Approval Officer

Why This Role Matters
The Approval Officer ensures that medical pre-approvals and insurance claims are accurately evaluated, coded, and processed in accordance with medical guidelines and regulatory standards. This role is critical for maintaining smooth healthcare operations, supporting patients, and ensuring compliance with insurance and auditing requirements.

Job Description
The Approval Officer evaluates pre-approval requests for medical necessity, codes services accurately, liaises with insurance and internal departments, manages second opinions and case escalations, and provides reports and training as needed. The role also supports auditing processes and ensures seamless workflow across shifts.

Key Features
• Position: Approval Officer
• Company: NMC Healthcare UAE
• Location: Al Ain
• Employment Type: Full-Time
• Job Category: Physician / Administrative Support
• Experience Required: Minimum 2 years in insurance claims management/adjudication

Responsibilities
• Evaluate pre-approval requests for medical necessity and code according to accepted medical coding rules (ICD, CPT, DRG, HCPCS)
• Respond promptly to insurance/TPA queries and liaise with relevant departments
• Receive, evaluate, and escalate second opinion cases and case management issues
• Perform night shifts and work on public holidays as per duty roster
• Prepare daily activity and monthly management reports
• Handle auditing processes, arrange documents, and coordinate with coders for external audits
• Attend meetings and presentations related to insurance and approvals
• Train front office staff, receptionists, and nurses on insurance processes and updates
• Prepare cost estimates for procedures for cash-paying patients
• Adjust duties during emergency or unplanned absences of colleagues
• Manage pending cases and ensure smooth handover to next shift
• Perform additional tasks assigned by the HOD within the scope of the role

Required Qualification
• MBBS degree from a recognized university
• Minimum 2 years’ experience in insurance claims management/adjudication
• Experience in medical coding (ICD, CPT, DRG, HCPCS)
• Excellent written and verbal English communication skills
• Flexible, able to work under pressure, and strong problem-solving abilities
• Proficient in Microsoft Office and computer applications

Important Requirements
• Ability to work collaboratively with multiple departments
• Strong attention to detail and accuracy in coding and reporting
• Knowledge of insurance guidelines and healthcare compliance standards

Employment Options
• Full-time, on-site at NMC Healthcare, Al Ain

What We Offer
• Exposure to insurance claims and auditing processes in a large healthcare network
• Professional growth in healthcare administration and coding
• Opportunity to interact with multidisciplinary healthcare teams

Experience and Skills
• Insurance claims evaluation and adjudication
• Medical coding expertise (ICD, CPT, DRG, HCPCS)
• Reporting, auditing, and training skills
• Effective communication and teamwork

Salary Insights
• Competitive salary (details not disclosed)

Company Overview
NMC Healthcare UAE is a leading healthcare provider in the UAE, delivering high-quality services across multiple disciplines with a focus on patient safety, operational excellence, and compliance with medical and insurance standards.

FAQs
Who can apply?
MBBS graduates with insurance claims and coding experience

Where is the job located?
Al Ain, UAE

Is prior coding experience mandatory?
Yes, experience in ICD, CPT, DRG, and HCPCS coding is required

What is the employment type?
Full-time, on-site

Application Tips
• Highlight experience in insurance claims management and coding
• Showcase ability to manage audits, reports, and case escalations
• Emphasize flexibility and teamwork skills