NMC HealthApproval Officer
NMC Health is hiring an Approval Officer in Abu Dhabi, United Arab Emirates. Level rates it ; you can apply on NMC Health.
Level's read on this job
- Little AI ●○○○ is how Level rates this role: aI is not part of the work.
- Tools and skills the posting cites include Microsoft Office, Icd and Cpt.
- Level classifies it as a mid-level role.
- Level lists 126 other open roles at NMC Health.
- The role was posted within the past week.
AI in this role
Approval Officer responsible for evaluating pre-authorization medical requests, applying medical coding rules, and managing insurance claims.
Evaluate the pre-authorization requests from medical necessity for the requested service according to the medical data provided and accurately code the service description codes stated on the prior authorization requests, according to accepted medical coding rules, medical guidelines and policy’s schedule of benefits.
Response to Insurance/ TPA queries and liaise with concerned department.
Responsible for receiving, evaluating and escalating second opinion cases and case management.
Perform night shift duty to sustain any issues and queries related to Authorization department.
Prepares reports of daily activity as requested for management and assists management in monthly reports as requested.
Evaluate pre-authorization requests for medical necessity based on the medical data provided and accurately code service description codes in accordance with accepted medical coding rules, medical guidelines and the policy's schedule of benefits.
Respond to insurance/TPA queries and liaise with the concerned departments.
Receive, evaluate and escalate second opinion cases and case management requests.
Perform night shift duties to address any issues and queries related to the Authorization Department.
Prepare daily activity reports as requested by management and assist with monthly reporting.
Bachelor's Degree in Medicine (MBBS) from a recognized university.
Minimum 2 years of experience in insurance claims management/adjudication.
Experience in medical coding (ICD, CPT, DRG and HCPCS).
Excellent command of written and spoken English.
Flexible and able to work under pressure.
Excellent knowledge of Microsoft Office applications.
How we rate this
Approval Officer at NMC Health rates 0 out of 100 for how much of the daily work is AI. That makes it Little AI (AI Level 1 of 4). The level is about AI in the job, not seniority.
Little AI. AI is not part of the work.
- ●●●● Builds AI80 to 100
- ●●●○ Works on AI60 to 79
- ●●○○ Uses AI40 to 59
- ●○○○ Little AI0 to 39
Levels come from how often the tools, models and workflows of the role are named in the posting itself. Read the description and count the AI tools, models and workflows it names.
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Skills and AI tools this role asks for
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- What's a project where you used Microsoft Office hands-on?
- Walk me through how you've used Icd in your day-to-day work.
- What are the limits of Cpt that you've run into, and how did you work around them?
- What's a project where you used Drg hands-on?
- Walk me through how you've used Hcpcs in your day-to-day work.
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- List these exact terms on your resume: Microsoft Office, Icd, Cpt, Drg, and Hcpcs. An applicant tracking system matches the wording, not the idea.
- Attach one line of real, concrete experience to at least one of them. A tool named with nothing behind it rarely survives a human read.
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