Medical Coder and Insurance Approval Officer

Job Role

Medical Coding

• Review diagnoses, procedures, and treatments in patient records for inpatient and outpatient encounters.
• Assign ICD-10-CM, CPT, and HCPCS codes according to national and payer-specific guidelines.
• Select principal diagnoses, secondary diagnoses, and procedures relevant to reimbursement and clinical accuracy.
• Query physicians when documentation is unclear or insufficient.
• Maintain knowledge of coding changes, DOH/DHA directives, and payer requirements.
• Conduct coding audits and provide feedback and training support to clinical staff.

Insurance Approval and Claims

• Evaluate and process pre-approval requests for medical necessity based on documentation and policy terms.
• Submit authorization requests to insurance companies and TPAs and follow up on their status.
• Manage claim submission and resubmission processes for completeness and accuracy.
• Investigate and resolve claim rejections and denials with physicians, billing teams, and payers.
• Track approvals, resubmissions, and outstanding claims to reduce delays and revenue leakage.
• Maintain records of approvals, denials, and payer correspondence.

Compliance and Reporting

• Ensure coding and approval activities comply with UAE healthcare regulations and payer contracts.
• Maintain patient confidentiality in line with data protection standards.
• Prepare daily, weekly, and monthly reports on productivity, turnaround times, rejection rates, and outstanding claims.
• Support internal and external coding and insurance claims audits.

Qualifications and Experience

• Bachelor’s degree or Diploma in Health Information Management, Medical Coding, Healthcare Administration, Nursing, or Allied Health.
• CPC certification from AAPC is preferred or described as mandatory in the source.
• ICD-10-CM coding knowledge with certification or relevant experience.
• Two to five years of experience in medical coding and/or insurance pre-approval within a UAE healthcare, TPA, or insurance setting.
• Prior experience with MOHAP coding standards and UAE payer systems is highly preferred.

Skills and Knowledge

• Strong knowledge of medical terminology, anatomy, and physiology.
• Proficiency in ICD-10-CM, CPT, and HCPCS coding systems.
• Familiarity with UAE insurance claim management systems, including Riyati and e-Claim.
• Strong understanding of UAE insurance, pre-approval, and claims adjudication processes.
• Excellent written and spoken English communication skills; Arabic is an advantage.
• Proficiency in Microsoft Office and hospital information systems.

Pay

• AED 2,500 to AED 3,500 per month.

Work Location

• Work is performed in person.