{"id":28090,"date":"2025-01-28T08:00:10","date_gmt":"2025-01-28T08:00:10","guid":{"rendered":"https:\/\/www.whitehattoolbox.com\/jobs\/approval-officer\/"},"modified":"2025-01-28T08:00:10","modified_gmt":"2025-01-28T08:00:10","slug":"approval-officer","status":"publish","type":"post","link":"https:\/\/www.whitehattoolbox.com\/jobs\/approval-officer\/","title":{"rendered":"Approval Officer"},"content":{"rendered":"

Apply medical knowledge and best insurance practice while reviewing and verifying the Pre Approval requests (OP\/ IP) received from different departments to obtain authorizations as required by insurance companies dependent upon the plan coverage for all patients.<\/span>Ensure that the details of the Pre Authorization Requests are in line with the regulators’ standards especially the claim adjudication Rules and Business Rules.<\/span>Handling the rejected pre authorization and get required justification from the treating doctor to resend it to Insurance Company and obtain the approval.<\/span>Prepares reports of daily activity as requested for management and assists management in month end reporting as requested.<\/span>Responsibilities<\/b><\/span>Evaluate the Pre Approval requests from medical necessity for the requested service according to the medical data provided and accurately code the service description codes stated on the prior authorization requests, according to accepted medical coding rules, medical guidelines and policy’s schedule of benefits<\/span>Response to Insurance\/ TPA queries and liaise with concerned department.
\n Responsible for receiving, evaluating and escalating second opinion cases and case management<\/span>Perform night shift duty to sustain any issues and queries related to Authorization department
\n Prepares reports of daily activity as requested for management and assists management in monthly reports as requested<\/span>Qualifications<\/b><\/span>Bachelor Degree in Medicane (MBBS) graduate from a recognized university.
\n Experience in Insurance Claims management\/adjudication (minimum 2 years)
\n Experience in Medical Coding ICD, CPT, DRG and HCPCS.<\/span>Excellent command of oral and written English.
\n Flexible and able to work under pressure
\n Excellent knowledge of Microsoft applications<\/span>You will be redirected to the company website to apply for this position.<\/p>\n

Apply Now<\/a> <\/b><\/center><\/p>\n","protected":false},"excerpt":{"rendered":"

Apply medical knowledge and best insurance practice while reviewing and verifying the Pre Approval requests (OP\/ IP) received from different departments to obtain authorizations as required by insurance companies dependent upon the plan coverage for all patients. Ensure that the details of the Pre Authorization Requests are in line with the regulators’ standards especially the<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[31],"tags":[],"class_list":["post-28090","post","type-post","status-publish","format-standard","hentry","category-jobs-in-uae"],"jetpack_publicize_connections":[],"jetpack-related-posts":[{"id":142408,"url":"https:\/\/www.whitehattoolbox.com\/jobs\/were-hiring-pre-authorization-medical-officer\/","url_meta":{"origin":28090,"position":0},"title":"We\u2019re Hiring Pre-authorization medical Officer","author":"Admin","date":"February 19, 2026","format":false,"excerpt":"- Review in-patient & out-patient approval requests in accordance with medical guidelines, CCHI and policy coverage - Review a healthcare service that another clinical professional might propose to a plan member - Determine whether the service is medically necessary and appropriate and whether the health plan will cover it -\u2026","rel":"","context":"In "Jobs In Gulf Countries"","block_context":{"text":"Jobs In Gulf Countries","link":"https:\/\/www.whitehattoolbox.com\/jobs\/category\/jobs-in-gulf-countries\/"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":135233,"url":"https:\/\/www.whitehattoolbox.com\/jobs\/were-hiring-tamheer-elite-program\/","url_meta":{"origin":28090,"position":1},"title":"We\u2019re Hiring Tamheer -Elite Program","author":"Admin","date":"January 28, 2026","format":false,"excerpt":"Job Description Manage members\u2019 experience with the relevant operational functions to ensure that services are delivered to the members end to end in every touch point of their journey on a timely manner. 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