Group Auditor - IP Coding

NMC Group; Abu Dhabi; On-site; AED 180,000 - 300,000; Full time

Job summary

NMC Group is seeking a Group Auditor - IP Coding to perform detailed audits of inpatient cases, ensuring coding accuracy, DRG placement, and medical necessity in Abu Dhabi.

You will collaborate with CDI, coding, and revenue teams; report findings, support audit readiness, and drive corrective actions across multiple hospitals while staying current with UAE regulations.

Qualifications

• Bachelor’s degree in nursing or Health Information Management, or Healthcare Administration.
• Holding valid Coding certification (AAPC or AHIMA).
• Deep understanding of UAE DRG system, inpatient coding, billing workflows, and medical necessity guidelines.
• Strong analytical skills to interpret complex clinical cases and DRG structures.

Responsibilities

• Conduct comprehensive audits of inpatient claims, coding accuracy, DRG assignment, LOS justification, and documentation completeness.
• Verify that clinical documentation appropriately supports coded diagnoses, procedures, and DRG weight.
• Audit high-value claims, clinical high-risk specialties, and cases flagged for denials or variances.
• Identify inpatient revenue leakage including under-coding, missed comorbidities, incorrect DRG shifts, undocumented services, and lost charges.
• Detect patterns of coding/documentation gaps leading to reduced reimbursement.
• Analyze trends in inpatient denials, takebacks, and medical necessity disputes.
• Develop detailed corporate audit reports including findings, risk scoring, variance analysis, and recommendations.
• Present audit insights to hospital leadership and corporate RCM teams.
• Collaborate with facility teams to close findings, implement corrective actions, and track post-audit improvement.
• Provide feedback to CDI, coding, and case management for improving clinical documentation quality.
• Contribute to training and awareness sessions on common audit findings and prevention strategies
• Stay informed of changes in UAE healthcare regulations, payer policies, and compliance standards to keep audit procedures current

Skills

Inpatient coding

DRG systems

Medical necessity

Audit tools

Analytical skills

Documentation review

Education

Bachelor’s degree in nursing

Coding certification (AAPC or AHIMA)

Tools

EMR

HIS

Coding systems

Audit tools

Job description

Group Auditor - IP Coding performs detailed audits of inpatient cases, including documentation, coding, charge capture, medical necessity, LOS justification, and DRG placement. The role evaluates adherence to UAE payer rules, DRG guidelines, and internal standards across multiple hospitals. The Auditor collaborates closely with coding, CDI, revenue integrity, case management, and clinical teams to communicate findings, drive corrective actions, and monitor improvements. The position also supports external audit preparedness, internal risk mitigation, and enterprise-wide compliance initiatives.

Responsibilities

The post holder will:

Conduct comprehensive audits of inpatient claims, coding accuracy, DRG assignment, LOS justification, and documentation completeness.

Verify that clinical documentation appropriately supports coded diagnoses, procedures, and DRG weight.

Audit high-value claims, clinical high-risk specialties, and cases flagged for denials or variances.

Identify inpatient revenue leakage including under-coding, missed comorbidities, incorrect DRG shifts, undocumented services, and lost charges.

Detect patterns of coding/documentation gaps leading to reduced reimbursement.

Analyze trends in inpatient denials, takebacks, and medical necessity disputes.

Develop detailed corporate audit reports including findings, risk scoring, variance analysis, and recommendations.

Present audit insights to hospital leadership and corporate RCM teams.

Collaborate with facility teams to close findings, implement corrective actions, and track post-audit improvement.

Provide feedback to CDI, coding, and case management for improving clinical documentation quality.

Contribute to training and awareness sessions on common audit findings and prevention strategies

Stay informed of changes in UAE healthcare regulations, payer policies, and compliance standards to keep audit procedures current

Qualifications

Education and Certification: Bachelor’s degree in nursing, Life Sciences, Health Information Management, or Healthcare Administration. Holding valid Coding certification ( AAPC or AHIMA)

Knowledge and Skills:

Deep understanding of UAE DRG system, inpatient coding, billing workflows, and medical necessity guidelines.

Strong analytical skills to interpret complex clinical cases and DRG structures.

Proficiency in EMR, HIS, coding systems, and audit tools.

Strong written and verbal communication for preparing detailed corporate‑level audit reports.

Ability to work independently and collaborate with multi-disciplinary teams across several facilities.

Experience:

DRG validation and severity level evaluation

Medical necessity and LOS audits

High-cost drug, device, and procedure justification

Denial root-cause analysis & compliance reporting

Revenue leakage detection in inpatient settings

Clinical documentation review & CDI alignment

Minimum 4–6 years in inpatient coding/auditing or RCM operations within a UAE healthcare organization

Job Info

• Job Identification 11317
• Job Category Administration
• Job Schedule Full time
• Locations NMC Group Services LTD, Abu Dhabi, AE