IP & OP Approvals Officer
Job Description
We are seeking a detail-oriented and performance-driven IP & OP Approvals Officer to streamline insurance workflows and optimize revenue cycle efficiency. The ideal candidate will act as a critical bridge between clinical operations and insurance providers, ensuring timely approvals, accurate coding validation, and seamless claims processing.
Key Responsibilities
- Manage Inpatient (IP) and Outpatient (OP) approvals in line with UAE insurance regulations
- Coordinate with insurance providers to secure pre-authorizations and approvals within defined TATs
- Review and validate medical coding (ICD/CPT) for accuracy and compliance
- Ensure timely submission and follow-up of insurance claims and approvals
- Handle claim rejections, resubmissions, and reconciliation processes
- Conduct internal audits to minimize revenue leakage and ensure coding compliance
- Liaise with doctors, coders, and billing teams to resolve discrepancies
- Maintain proper documentation aligned with UAE payer requirements and DHA standards
Eligibility Criteria
- ✔ Mandatory: Certified Medical Coder or Medical Doctor
- ✔ Proven UAE experience in IP & OP approvals or RCM operations
- ✔ Strong understanding of insurance claims lifecycle and payer protocols
- ✔ Expertise in ICD/CPT coding systems and compliance standards
- ✔ Experience in claims auditing, approvals, and reconciliation workflows
Core Competencies
Strong knowledge of UAE healthcare insurance ecosystem
Analytical mindset with strong attention to detail
Ability to manage high-volume workflows with accuracy
Effective communication and stakeholder coordination
Problem-solving approach to claim denials and process gaps
