Job Description
Requirements:
- Minimum 2 years of hands-on experience processing Inpatient and Day Case pre-authorization requests within the UAE healthcare sector.
- Strong knowledge of **DOH Abu Dhabi regulations, insurance policies, payer guidelines, and medical necessity criteria.
- Experience handling admissions, surgical procedures, extensions of stay, and high-value approvals.
- Ability to review medical reports, clinical documentation, treatment plans, and supporting attachments.
- Strong understanding of DRG-related admissions, clinical justifications, medical necessity, and insurance coverage limitations.
- Experience coordinating with Daman, insurance companies, TPAs, physicians, and hospital departments.
- Strong follow-up skills for pending approvals, insurance queries, rejections, reconsiderations, and appeals.
- Familiarity with ICD-10-CM, CPT, HCPCS, DRG, and hospital approval systems.
- Healthcare-related academic qualifications are preferred.
GENERAL REQUIREMENTS
✅ Previous Abu Dhabi healthcare insurance experience is essential.
✅ Excellent knowledge of insurance processes and regulatory compliance.
✅ Immediate joiners or candidates with a short notice period are preferred.
Ready to apply?
Review the requirements, then send your application to the employer.
