PBM Pre-Approval Officer

**Accumed** is actively Hiring for an experienced **PBM Pre\-Approval Officer** to join a Government Hospital in **Umm Al Quwain, UAE**. Interested candidates who meets the below mentioned criteria can send your CV here. **Kindly Note:** This role is open to all nationalities. carefully read the Job requirements before applying as only candidates who meet the below mentioned criteria will be contacted for an Interview. Immediate joiners preferred. **Location:** Umm Al Quwain, UAE **Industry:** Government Hospital / Healthcare **Employment Type:** Full\-time **Key Responsibilities** * Process and manage **PBM pre\-approval requests** accurately and within required timelines. * Handle **Riyaati portal approvals and submissions** in accordance with payer and regulatory requirements. * Review patient eligibility, prescriptions, clinical information, and supporting documents for approval. * Submit healthcare claims and ensure accurate and complete documentation. * Monitor and follow up on pending approvals and coordinate with relevant departments, physicians, and insurance/PBM teams. * Review and resolve **claim rejections, denials, and approval issues**, ensuring appropriate corrective action. * Maintain accurate records of approvals, submissions, rejections, and related correspondence. * Ensure compliance with UAE healthcare insurance and medication\-related requirements. * Handle pre\-approvals involving **high\-cost medications and controlled medications** with appropriate attention to regulatory and documentation requirements. * Coordinate with pharmacy, medical, billing, RCM, and insurance teams to ensure smooth approval and claims processes. **Requirements** * **Bachelor’s or Master’s Degree in Pharmacy** is mandatory. * **2–3 years of relevant UAE experience** in PBM, pre\-authorization, healthcare insurance, or claims. * Hands\-on experience with **Riyaati portal approvals** is required. * Experience in **claims submission and handling claim rejections/denials**. * Good understanding of UAE healthcare insurance and pre\-approval processes. * Strong knowledge of **high\-cost medications and controlled medications**. * Good understanding of pharmacy/medication documentation and insurance requirements. * Strong communication, coordination, and problem\-solving skills. * Ability to work effectively in a hospital environment and coordinate with multiple stakeholders. * Immedaite joiners or 1 month notice period only accepted. **Preferred Candidate Profile** Candidates with experience in **government hospitals, hospitals, healthcare groups, PBM companies, insurance companies, or healthcare RCM environments** will be preferred. Pay: AED5,000\.00 \- AED5,500\.00 per hour Expected hours: 48\.0 per week Work Location: In person