Inpatient Preauthorization Coder

About the role

The Inpatient Preauthorization Coder reviews and assigns ICD-10-CM, ICD-10-PCS and DRG codes for inpatient admissions in line with UAE health authority regulations (DHA, HAAD, MOH) and insurance payer policies. The role supports medical necessity, speeds up preauthorization decisions and reduces claim denials for the Third-Party Administrator (TPA). It reports to the Manager – IP Authorization within the Operations department.

Key responsibilities

• Assign and validate ICD-10-CM, ICD-10-PCS and DRG codes from medical records, ensuring alignment with DHA/HAAD/MOH standards and medical necessity
• Review inpatient preauthorization requests against UAE payer policies and collaborate with providers to clarify documentation gaps
• Identify utilization trends and areas of fraud, waste and abuse
• Maintain audit-ready records and stay current on coding updates, insurance circulars and reporting requirements
• Liaise with hospitals, physicians and insurers to resolve coding or authorization disputes and give providers feedback on common coding errors

Required profile

• Bachelor's degree in nursing, Allied Health Sciences or a related field (preferred)
• Certification as CPC (Certified Professional Coder); CIC or CCS certification is an advantage
• 3+ years of inpatient coding experience, preferably in a UAE hospital, insurance company or TPA
• Familiarity with UAE insurance preauthorization workflows
• Willingness to work in shifts

Required skills

• Strong knowledge of DRG-based reimbursement and UAE insurance policies
• Ability to interpret medical records and high accuracy in coding (target of at least 95% audit compliance)
• Strong communication across departments and with external service providers