Medical Authorisation Officer with a Degree in Medicine (UAE National Only)
Job: Full Time
Abu Dhabi, UAE

Employer Description
The National Health Insurance Company – Daman, is the UAE’s largest health insurance provider, and is headquartered in Abu Dhabi. H.E. Khaled Bin Shaiban Almehairi serves as Chairman of the National Health Insurance Company

Job Description

• Evaluate medical necessity of requested service according to medical data provided and accurately code service description stated on the prior authorisation requests, based on accepted medical coding rules, medical guidelines and policy’s schedule of benefits
• Ensure that proper documentation of the data including business decisions are correctly done on the system with focus on accuracy and efficiency and quality
• Ensure that medical ethics are always applied and respected while performing duties
• Constantly work on improving TAT and relevant functional/personal competencies
• Report suspected cases of fraud and abuse by healthcare providers to respective Supervisor
• Ensure cases needing Case Management intervention are escalated based on communicated criteria

Requirements:

• Minimum 1 year of clinical experience
• Experience in any of the medical units of a health insurance company or third-party administrator (TPA) is a plus
• Certification in the medical coding systems is a plus
• Bachelor’s degree in medicine

For more details, please scroll down & see the details.

Daman Health