Precertification Officer

About the role

The Precertification Officer handles incoming medical authorization requests, verifies eligibility, and ensures that treatments are necessary, appropriate, and cost‑effective. The role provides high‑quality service to clients and medical providers, supporting them throughout the authorization process.

Key responsibilities

• Receive and assess external requests, check claim eligibility, and issue medical treatment authorizations.
• Complete authorization data on TATSH according to policy wording and medical reports.
• Liaise with the Precertification Doctor and Team Leader for complex or high‑cost cases requiring medical approval.
• Communicate authorization details to clients, offering procedural and medical advice.
• Maintain confidential member data and follow internal claims procedures.
• Assist patients at the field level, verify discharge bills, and coordinate with regional offices.

Required profile

• Bachelor's degree in Nursing.
• Minimum 1 year experience in the health‑care industry (TPA, insurance, hospital, or medical centre).
• Physically fit and legally permitted to work in the country of operation.
• Proficient in MS Office (Excel, Word, Outlook, PowerPoint) and internet research.

Required skills

• Microsoft Excel
• Microsoft Word
• Microsoft Outlook
• Microsoft PowerPoint