Inpatient Preauthorization Coder

Statements in this Job Description are intended to reflect, in general, the duties and responsibilities of the position, but they are not to be interpreted as totally inclusive. NAS Neuron Heath Services LLC is an equal opportunity employer. Internal Information - Do Not Distribute JOB DESCRIPTION POSITION: Inpatient Pre-authorization Coder REPORTING TO: Manager – IP Authorization DEPARTMENT: Operations – InPatient Authorization 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 1. Coding & Clinical Review • 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. 2. Preauthorization & Utilization Management • 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. 3. Compliance & Regulatory Adherence • 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. 4. Communication & Stakeholder Coordination Statements in this Job Description are intended to reflect, in general, the duties and responsibilities of the position, but they are not to be interpreted as totally inclusive. NAS Neuron Heath Services LLC is an equal opportunity employer. Internal Information - Do Not Distribute • 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 in shifts. 4. COMMUNICATIONS AND WORKING RELATIONSHIPS The job holder interacts with all Departments within NNHS and other service providers. He/ She must ensure seamless communication between all departments for the smooth operations and to achieve the organizational objective. He/ She must be able to foster strong internal & external communication standards. 5. OPERATING ENVIRONMENT He/she works in an air-conditioned environment and spends most of the day at desk. The Jobholder’s working hours are flexible as per weekly schedule within the boundaries of the UAE labor law. The job holder is not exposed to any obvious hazards. Disclaimer: I hereby confirm that I have read the general outline of duties and responsibilities expected of me and I hereby confirm readiness and acceptance. Signature: _________________ Name of Employee Date: About The Cigna Group Doing something meaningful starts with a simple