Medical Insurance Doctor – Approvals Specialist
DAMANA · Dubai
Job description
About the role
We are seeking a qualified Medical Doctor to join our Dubai TPA team as an Approvals Specialist. You will be responsible for reviewing pre‑approval requests from hospitals and clinics, ensuring compliance with policy terms, and delivering high‑quality service to members and clients.
Key responsibilities
- Review and approve pre‑approval requests in the Claims Management System, applying policy terms and conditions.
- Coordinate with the Provider Relations Department to resolve pricing or CPT code discrepancies.
- Collaborate with the Clinical Team on complex admission cases.
- Respond to member and client inquiries regarding pre‑approval status, eligibility, and plan benefits.
- Document all calls and complaints, supporting the Customer Service Department as needed.
- Contribute to process improvement initiatives and provide recommendations to the Team Leader.
- Follow Operating Procedures Manual and company policies.
- Work on rotating shifts and weekends as required.
Required profile
- MBBS degree.
- 3‑5 years of experience in medical approvals or claims processing.
- Strong knowledge of insurance policies, pre‑certification processes, and CPT coding.
Required skills
- Medical approvals
What we offer
- Competitive compensation package.
- Professional development opportunities within a leading insurance provider.
- Dynamic, multicultural work environment in Dubai.
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Published 1 month ago
Expires 1 week from now
61 views · 0 interested
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DAMANA
Dubai
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