Junior RCM Officer ( Pre Authorization )

KEY RESPONSIBILITIES AND DUTIES:Reviews and processes pre-authorization requests from healthcare providers (hospitals, laboratories, pharmacies) to determine if services are covered.Verifies patient details and insurance eligibility for all pre-authorization requests.Communicates approval or rejection decisions to healthcare providers and patients based on pre-established criteria.Reviews medical documentation submitted with pre-authorization requests to confirm the medical necessity and compliance with insurance policies.Maintains accurate records of all processed pre-authorization requests and ensures proper documentation for audits.Resolves issues with incomplete or incorrect information related to pre-authorization requests.Works closely with the claims and billing departments to ensure that pre-authorization approvals are aligned with the submission of insurance claims.Responds to inquiries from patients, providers, and internal stakeholders regarding the status of pre-authorization requests.Additional RequirementsCandidates MUST have proven clinical experience in Pre-Authorization, Insurance Verifcation or a related field in a healthcare setting for 2 -3 years.Bachelor’s degree in a relevant field healthcare, business administration, or equivalent 2-3 years hospital/clinic experience in GCCArabic Speaker will be an advantage