Assistant Medical Coder7 Full Time

Position: Assistant Medical Coder – Revenue Management

Duties And Responsibilities:

• Establish and maintain the diagnostic/procedural coding system as approved by the hospital’s medical/administrative directive
• Ability to work independently with minimal supervision
• Maintain confidentiality regarding department activities.
• Code all relevant, current and documented diagnoses and procedures as performed by attending physicians utilizing the appropriate ICD coding
• Abstract all demographic, statistical and medical information from each patient record and enter the data into the coding/abstracting system
• Understands Health Insurance Policy Terms, Coverage, Exclusions & Approval requirements as per the contractual and regulatory obligations.
• Review Electronic statement for all prescribed diagnostics and pharmacy items along with procedures and complications as documented in the EMR, Claim Form/ operative reports. Assign appropriate codes and send a request to physician wherever required. Ensure Documentations is completed and specific for coding to the highest specificity/Severity. Applies the appropriate guidelines for assignment of principal and secondary procedures utilizing the CPT 4 procedure code when reviewing claims with Outpatient Coordinator for billing purposes.
• Reviews Approval tracks are entered for all approval required services like Antenatal Consultations, Diagnostics like CT, MRI, and Surgical Procedures etc. as per the Quick Chart /DPP. Billed Services should be as per the Approval provided by the Insurer/Corporate.
• Reviews services repeated within the same day and clarifications/medical necessity is sought from Physician/Labs / Medical Imaging etc.
• Reviews CEED filtered Medical Necessity / Coding edits and ensures additional ICD codes are applied as required/ suggested by the Insurance Coordinator.
• Review rejections from payers and assign appropriate codes based on response from physicians for queries raised after rejection
• Reporting of Utilization Trends, Documentation Issues, and Billing Issues for Process / Performance improvement.
• Ensure Physician Queries are sent and reported.
• Ensure daily productivity is achieved.
• Ensure delegated Insurance, Corporate and Self Pay batches are closed and dispatched in line with the dispatch Schedule.

Qualifications & Skills:

• Graduate of a recognized coding technician program or equivalent CCS
• Should maintain the credentials valid with the concerned body. E.g.: AHIMA
• Medical Graduate preferred.

Professional Experience:

• Minimum 3 years’ experience in ICD-9-CM or ICD-10 coding in organization handling claims.
• Proficiency in English Language is Mandatory.
• Proficiency in communicating in Arabic will be an added advantage
• Knowledge of Health Insurance Policy Terms, Coverage & Exclusions in UAE will be an advantage.
• Proficiency in working with MS Office applications  like Excel , Outlook , Word is recommended
• Good Communication and Interpersonal skills are recommended.