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Insurance Coordinator - OP Approvals (Immediate Joiner)

Metabolic
Dubai, UAE
Full Time
Entry
Onsite
1 weeks ago
Certified Professional CoderEHR SystemsMicrosoft OfficeCPT CodingICD CodingDenial Management
Free

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About Metabolic.Health

  • Metabolic.Health is an integrated metabolic care provider in the UAE, combining clinical care, diagnostics, and data driven models to improve outcomes in diabetes and metabolic health.

Role Overview

  • The Insurance Coordinator OP Approvals manages outpatient insurance approvals and authorization workflows, ensuring timely approvals, accurate documentation, and compliance with payer rules.

Key Objectives

  • Ensure all outpatient services receive approvals before treatment
  • Maintain zero tolerance for unauthorized services
  • Achieve approval turnaround within payer SLA timelines
  • Maintain less than 3 percent denial rate due to authorization errors
  • Ensure adherence to DHA regulations and payer policies
  • Maintain complete audit ready authorization records

Core Responsibilities

  • Verify insurance eligibility and benefits before initiating approval requests
  • Submit pre authorization requests with complete clinical documentation
  • Track approvals, extensions, and validity periods to prevent service disruptions
  • Escalate urgent or delayed approvals to payers and internal leadership
  • Ensure physician orders, clinical notes, and diagnostic reports support medical necessity
  • Validate CPT and ICD coding alignment with requested services
  • Maintain organized digital records of approvals, correspondence, and payer responses
  • Liaise with insurance companies and TPAs to expedite approvals
  • Communicate approval status to front office, clinical teams, and patients
  • Clarify payer requirements and disseminate updates to relevant teams
  • Investigate approval denials and implement corrective actions
  • Identify trends in authorization rejections and recommend process improvements

Requirements

  • Certified Professional Coder credential
  • Bachelor's degree in Health Information Management, Nursing, or related field
  • Strong knowledge of DHA regulations and UAE payer rules
  • Minimum 2 years of coding and denial management experience in the UAE
  • Proficiency in EHR systems, coding tools, and Microsoft Office
  • Strong analytical skills and attention to detail
  • Effective communication with clinical, billing, and insurance teams
  • Experience in outpatient clinics or specialty centers, preferably endocrinology or metabolic care

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