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Approval Officer

Company

NMC

Location

ras al khaimah, ras al khaimah

Type

Full-time

Responsible for reviewing clinical documentation and assigning standardized medical codes to diagnoses, procedures, and treatments for billing, insurance claims, and maintaining accurate medical records.

Responsibilities

  • Follow the mandatory SOP, checklist and relevant payer and coding guidelines.
  • Checking demographic details of patient and make sure the front desk should select the proper regulatory policy (DHPO or RIAYATI).
  • Proper documentation is entered in the chart/EMR/claim form by the doctors.
  • Supporting details/justification available in EMR of all investigations done.
  • Checking all CPT codes entered are correct based on CPT guidelines.
  • Checking excluded ICD and CPT based on coding guidelines.
  • Approved services and rendered services are matched.
  • Ensuring all requested investigations are done and invoiced.
  • Check the claim with correct receiver and payer name before finali...

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