Specialist – Authorization (Tawam Fertility Center)

Job Overview

The Specialist - Authorization at Tawam Fertility Center manages prior-authorization and pre-certification activities for services requiring payer approval. The role coordinates with insurers, physicians, clinical teams and patients, verifies benefits and eligibility, gathers clinical documentation and ensures authorization information is recorded accurately.

Key Responsibilities

• Initiate prior-authorization requests for services and procedures that require payer approval.
• Act as a key resource for SEHA prior-authorization requirements and processes.
• Collect clinical and administrative information needed to support authorization requests.
• Contact insurance companies through phone, fax and online portals to verify eligibility, benefits and authorization requirements.
• Update healthcare systems with accurate authorization, benefit and payer information.
• Coordinate with service-line teams when scheduling changes are necessary because of missing authorization or limited benefits.
• Support authorization of inpatient accounts and ensure timely notification to payers about admissions.
• Verify that approvals and pre-certifications correspond accurately to the actual procedure, test or service being delivered.
• Document authorization details, patient financial obligations and payer criteria clearly in the patient account.
• Coordinate with physicians, case management and utilization-review teams to obtain clinical information required by payers.
• Monitor email, fax and telephone requests and respond to pre-access authorization issues within defined timelines.
• Keep current with payer criteria, medical terminology, coding requirements and prior-authorization processes.

Requirements

• Healthcare certification such as CRCR and/or CHAM is desirable/required according to the posting.
• Experience in medical insurance verification and authorization; the posting references 1–3 years of prior authorization experience.
• Strong knowledge of healthcare revenue-cycle systems and insurance billing processes.
• Knowledge of medical terminology, ICD-10 and CPT-4; billing/coding experience is preferred.
• Understanding of payer contracts, authorization requirements, registration, verification, pre-certification and scheduling procedures.
• Proficiency in Microsoft Office and Outlook and strong communication skills.

Employment Details

• Company: Abu Dhabi Health Services Company- SEHA
• Location: Al Ain, Abu Dhabi, United Arab Emirates
• Employment Type: Full Time
• Industry: Hospitals and Health Care

How to Apply

Interested candidates can review the full vacancy details and apply through the provided LinkedIn application link.