Approval Officer - UAEN

2.0 JOB SUMMARY

2.1 Apply medical knowledge and best insurance practice while auditing / reviewing the claims prior submission, medical records and other documentation essential to justify the services rendered to the patient by the healthcare facility.

2.2 Ensure that the details of the claims are in line with the regulators’ standards especially the claim adjudication Rules and Business Rules.

2.3 Handling resubmission of rejected claims.

2.4 Reviewing Inpatient/ Outpatient Medical Claims

2.5 Reviewing unpaid and denied claims, preparing credit notes for denial accepted claims.