Dubai Insurance TPA

1. JOB PURPOSE
The Inpatient Preauthorization Coder is responsible for reviewing and accurately assigning ICD-10-CM, ICD-10-PCS, and DRG codes for inpatient admissions in compliance with UAE health authority regulations (DHA, HAAD, MOH) and insurance payer policies. This role ensures medical necessity for hospitalizations, facilitates timely preauthorization decisions, and minimizes claim denials for the Third-Party Administrator (TPA).
2. RESPONSIBILITIES AND DUTIES
<ol>
<li>Coding &amp; Clinical Review</li>
</ol>
· Assign and validate *ICD-10-CM, ICD-10-PCS, and DRG codes* for inpatient admissions based on medical records.
· Strong knowledge of CPT, and HCPCS Level II codes
· Ensure coding aligns with DHA/HAAD/MOH coding standards and supports medical necessity
<ol start="2">
<li>Preauthorization &amp; Utilization Management:</li>
</ol>
· Review inpatient preauthorization requests against UAE payer policies
· Collaborate with providers to clarify documentation gaps affecting authorization and coding.
· Identify potential utilization trends and areas of fraud waste and abuse
<ol start="3">
<li>Compliance &amp; Regulatory Adherence:</li>
</ol>
· Ensure compliance with UAE health insurance laws DHA/HAAD/MOH regulations
· Maintain audit-ready records.
· Stay updated on UAE coding updates, insurance circulars, and mandatory reporting requirements.
<ol start="4">
<li>Communication &amp; Stakeholder Coordination:</li>
</ol>
· Liaise with hospitals, physicians, and insurance companies to resolve coding or authorization disputes.
· Provide feedback to providers on common coding errors leading to rejections
3. KNOWLEDGE, SKILLS AND EXPERIENCE
· Bachelor’s degree in nursing, Allied Health Sciences or a related field (preferred)
· Certifications: Mandatory CPC- Certified Professional Coder, having CIC -Certified Inpatient Coder, CCS -Certified Coding Specialist is an advantage
· Experience: 3+ years of inpatient coding experience, preferably in a UAE hospital, insurance company, or TPA.
· Familiarity with UAE insurance preauthorization workflows
· Skills: Strong knowledge of DRG-based reimbursement and UAE insurance policies.
· Ability to interpret medical records.
· High accuracy in coding (target: ≥95% audit compliance).
· Willingness to work on shifts
Job Type: Full-time
Pay: AED9,000.00 - AED10,000.00 per month
Education:
<ul>
<li>Bachelor's (Preferred)</li>
</ul>
License/Certification:
<ul>
<li>Certified Professional Coder (Required)</li>
<li>Certified Inpatient Coder (Required)</li>
</ul>
Work Location: In person

In-Patient Coder - with CPC and CIC (TPA Insurance)

In-Patient Coder - with CPC and CIC (TPA Insurance)

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