Group Auditor - IP Coding

NMC Healthcare; Abu Dhabi; On-site; AED 180,000 - 280,000; Full time

Job summary

NMC Healthcare in Abu Dhabi seeks a Group Auditor - IP Coding to perform detailed audits of inpatient cases, including documentation, coding, charge capture, and DRG placement. The role collaborates with CDI, revenue integrity, and clinical teams to drive corrective actions.

You will stay updated on UAE regulations, contribute to training, and present findings to hospital leadership and corporate RCM teams, ensuring compliance and optimized reimbursement.

Qualifications

• Bachelor’s degree in nursing, Life Sciences, HIM, or Healthcare Administration.
• Valid coding certification (AAPC or AHIMA).
• Deep understanding of UAE DRG system, inpatient coding, billing workflows, and medical necessity guidelines.

Responsibilities

• Conduct comprehensive audits of inpatient claims and DRG assignment.
• Verify clinical documentation supports coded diagnoses and procedures.
• Audit high‑value claims and denials; identify risk areas.
• Identify revenue leakage from under‑coding and lost charges.
• Analyze trends in denials, takebacks, and medical necessity disputes.
• Prepare detailed audit reports with findings and recommendations.
• Present insights to hospital leadership and RCM teams.
• Collaborate with facility teams to close findings and track improvements.
• Provide feedback to CDI, coding, and case management for quality improvement.
• Stay updated on UAE healthcare regulations and payer policies.

Skills

DRG validation

Inpatient coding

Audit reporting

Medical necessity knowledge

Communication skills

Education

Bachelor’s degree in Nursing, Life Sciences, HIM, or Healthcare Administration

Coding certification (AAPC or AHIMA)

Tools

EMR/HIS systems

Coding systems

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