Executive, Preauthorization
Sukoon Insurance is seeking a Preauthorization Executive to manage medical audits and PAR administration within the health insurance domain. The role involves coordinating with providers, controlling costs, and ensuring adherence to regulatory SLAs in a 24/7 environment. The candidate must hold a clinical qualification and possess deep experience in claims adjudication and fraud control. You will also participate in process improvement initiatives and support the maintenance of SOPs.
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Experience
Experience not specified
Function
Healthcare Services
Work mode
Onsite, United Arab Emirates
Company
Tier 2
What you will work on
Sukoon Insurance is seeking a Preauthorization Executive to manage medical audits and PAR administration within the health insurance domain. The role involves coordinating with providers, controlling costs, and ensuring adherence to regulatory SLAs in a 24/7 environment. The candidate must hold a clinical qualification and possess deep experience in claims adjudication and fraud control. You will also participate in process improvement initiatives and support the maintenance of SOPs.
TAL's take
Stable role in the insurance sector with defined operational responsibilities.
Clear operational focus on medical audit and pre-authorization processes with well-defined KPIs.
Must haves
- Medical degree or relevant clinical qualification
- Experience in medical auditing and pre-authorization
- Experience in claims adjudication and FWA control
- Proficiency in MS Office and claims management systems
- Strong English communication skills
Tools and skills
Nice to have: icd, cpt.
About the company
Established insurance provider in the region.
Posts mentioning Sukoon Insurance
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Kaun firse uthe umeed lagane ko Pagal hone ko, Intezaar karne ko Kyuki ab saala umeed rakhe kaun Ki aasmaan me woh aashaayein dekhta hai Toh mahadev ki kasam dobara se phir khadhe ho jaaye magar Ab mood nhi hai Udd jaane mein hi sukoon hai Kahi aur aage badh jaane me hi bhalayi hai Magar yaad karenge kisi roz Kisi naye brahmand ke kisi aur kone me Kisi aur kahani ke kisi aur wajood me Phir daudh jaaenge iss kahani ki kisi aur yaad me Source: Internet
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