Medical Insurance Approval Executive

Job overview

Support medical-insurance approvals, eligibility checks, preauthorisations, follow-ups, modifications and denial management while coordinating with patients, doctors, insurers and the billing team.

Requirements

• Bachelor’s degree in nursing, pharmacy, medicine, life sciences, healthcare administration or a related field
• Medical coding certification such as CPC, CCS or CCA is preferred
• One to two years of UAE healthcare insurance approval experience
• Knowledge of UAE insurers and TPAs, including Nextcare, NAS/Neuron, MedNet, Daman, Sukoon and Al Madallah
• Familiarity with ICD-10-CM, CPT, HCPCS, medical terminology and medical-necessity requirements
• Experience using insurer portals and EMR/HIS systems for eligibility, preauthorisation and approval management
• Understanding of DHA and UAE payer guidelines, network benefits, exclusions, copayments, deductibles and approval limits
• Strong communication skills and proficiency in English, Microsoft Excel, email and basic reporting