Associate – Preauthorization (Contract)
Sukoon Insurance
وصف الوظيفة
About the role
The Associate, Preauthorization will handle electronic prior authorization (ePAR) and pharmacy benefit management (PBM) cases through calls and emails. You will ensure timely, accurate pre‑approvals while delivering excellent customer service to providers, pharmacies, and members.
Key responsibilities
- Review ePAR and PBM cases promptly and process them according to established guidelines.
- Issue accurate pre‑approvals to healthcare providers.
- Respond to inbound calls and emails from pharmacies, providers, and customers with professional service.
- Validate clinical data against diagnosis and procedure codes and adjudicate requests per policy and regulatory standards.
- Maintain effective communication with team members and supervisors, supporting departmental initiatives.
Required profile
- Bachelor’s degree in paramedical, nursing or related field; medical graduate preferred.
- 4‑5 years of experience in pre‑approval or PBM roles, including 1‑2 years in the UAE.
- Strong decision‑making ability to authorize eligible cases.
- Excellent written and verbal English; Arabic is an advantage.
- Familiarity with local insurance regulations and market practices.
Required skills
- Medical coding knowledge.
- Lean Six Sigma or other performance‑improvement methodologies.
- Proficiency with MS Office suite.
- Experience using health‑claim systems and MIS tools.
- Business process design, re‑engineering, and workflow mapping.
What we offer
- 1‑year contract position with shift‑based schedule.
- Entry‑level compensation and benefits package.
- Opportunity to work in a dynamic insurance environment.
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اطرحه هنا: ستصلك تفاصيل العرض كاملة عبر البريد الإلكتروني، فوراً.
منشور منذ 4 أسابيع
ينتهي 4 أسابيع من الآن
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Sukoon Insurance
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