Inpatient (IP) Approval Officer
- Location
- Al Ain, Abu Dhabi, United Arab Emirates
- Salary
- Not specified
- Company
- Akash pawar
Job description
• Role & Company / Project Overview Urgent vacancy for an Inpatient (IP) Approval Officer in Al Ain, Abu Dhabi, UAE within the Healthcare / Hospital / Revenue Cycle Management (RCM) domain. The role centers on managing pre-authorizations, insurance approvals, and clinical justifications for inpatient admissions and procedures. • Key Responsibilities & Daily Duties - Process Inpatient and Day Case pre-authorization requests efficiently within the UAE healthcare framework. - Handle admissions, complex surgical procedures, extensions of stay, and high-value approvals. - Review detailed medical reports, clinical documentation, treatment plans, and supporting attachments. - Formulate clinical justifications, evaluate medical necessity criteria, and manage insurance coverage limitations for DRG-related admissions. - Coordinate closely with Daman, private insurance companies, TPAs, attending physicians, and various hospital clinical departments. - Execute strong follow-up actions on pending approvals, insurance queries, rejections, reconsiderations, and appeals. - Navigate and operate ICD-10-CM, CPT, HCPCS, DRG coding references, and hospital pre-approval IT systems. • Required Qualifications, Skills & Experience - Minimum 2 years of hands-on experience processing Inpatient and Day Case pre-authorization requests within the UAE healthcare sector. - In-depth knowledge of DOH Abu Dhabi regulations, insurance policies, payer guidelines, and medical necessity criteria. - Healthcare-related academic qualifications are preferred. - Previous Abu Dhabi healthcare insurance experience is essential. - Excellent knowledge of insurance processes and regulatory compliance. • Working Hours, Shifts & Location Details - Job Location: Al Ain, Abu Dhabi, UAE (Hospital / Healthcare facility). - Notice Period: Immediate joiners or candidates with a short notice period are preferred. • Compensation & Benefits - Healthcare industry standard compensation commensurate with background. • Application Instructions - Submit an updated CV via LinkedIn direct message or by emailing the recruitment team.