Dental Claim Officer

JOB RESPONSIBILITY:

• The role operates within the Medical Operations Division and Authorisation Department, ensuring accurate, timely, and compliant processing of dental prior-authorisation requests.
• The role supports claims adjudication, patient care navigation, and medical case management while contributing to objective of balancing high-quality member care with cost efficiency and profitability.
• Key responsibilities include evaluating and processing dental prior-authorisation requests in line with defined daily targets, quality standards, and KPIs, while ensuring strict compliance with contractual prices, discounts, Schedule of Benefits, policy limits, and prior submission protocols.
• To utilises core systems such as Documentum and contributes to the development and implementation of dental authorisation guidelines.
• The role supports training initiatives for team members, escalates complex cases, provider trends, and operational issues to the supervisor, and reports suspected fraud or abuse.
• A strong focus on customer service, medical ethics, documentation quality, and continuous improvement is essential to safeguard organisational integrity and service excellence.
• Qualifications

Bachelor’s degree in Dental Surgery or Doctor of Dental Surgery.

• Experience in dental prior-authorisation or claims processing is preferred.

Job Types: Full-time, Permanent

Pay: AED5,000.00 - AED7,000.00 per month

Work Location: In person