Specialist, DRG Case Management

About the role

The Specialist, DRG Case Management will manage inpatient cases, ensure accurate DRG coding, and meet defined turnaround times in a high‑pressure, metric‑driven environment.

Key responsibilities

• Visit healthcare providers to review and manage inpatient cases, verifying DRG codes and severity levels.
• Coordinate with physicians and providers, negotiate costs, and ensure correct length of stay and compliance with insurance protocols.
• Adhere to regulatory guidelines, achieve case‑management targets, and ensure 100% compliance with ePAR processes.
• Prepare monthly analytical reports on DRG cases and billing.

Required profile

• Bachelor’s degree in Medicine (MBBS) and globally recognized coding qualifications.
• Minimum 5 years of coding experience with IR‑DRG and AP‑DRG, plus 1‑2 years UAE‑specific case management experience.
• Strong knowledge of UAE insurance industry, regulatory environment, and IP case pre‑approval protocols.

Required skills

• Medical coding (IR‑DRG, AP‑DRG)
• Advanced MS Excel proficiency
• Excellent English communication (written, spoken, reading)
• Problem‑solving and decision‑making abilities