Senior Medical Coder
Job Description
Senior Medical Coder (IBO Medical Center)
- Ensure 100% claim submission of IBO Medical center within the agreed time frame.
- Review outpatient clinical documentation and assign accurate CPT, ICD-10, and HCPCS codes.
- Ensure coding accuracy and compliance with DHA/MOH/DOH regulations and payer-specific requirements.
- Validate insurance approvals, coverage policies, and coding requirements before claim submission.
- Cross-check diagnosis and procedure codes with physician documentation for consistency.
- Collaborate with doctors and clinical staff to clarify diagnoses or obtain missing information.
- Support the billing team in resolving claim rejections or denials due to coding discrepancies.
- Keep updated with insurance guidelines, coding rule changes, and payer-specific circulars.
- Generate coding-related audit reports to ensure documentation and billing accuracy.
- Assist in internal and external audits, including compliance checks and pre-insurance assessments.
- Focus on zero rated rejection for all the submitted claims.
- Closely work with claim processing team to ensure timely claim submission (2nd of every Month) and resubmission (21 days) process is carried out effectively
- Complete special tasks assigned by the Reporting Manager.
- Complete the recon resubmission and closure with all insurance companies within the time line.
- Maintain relationship with customers by professional conduct and response to queries over standard guidelines in effective communication.
- Participate in ongoing training sessions and contribute to improving coding workflows.
Qualification & Experience:
- Bachelor’s Degree in a medical or healthcare-related field.
- Certified Professional Coder (CPC) or equivalent certification (AAPC/AHIMA recognized).
- Minimum 5–7 years of UAE experience in medical coding, specifically outpatient coding in Medical centers or Day care Surgery Centers in Northern Emirates.
- Certified Professional Coder (CPC) or equivalent certification (AAPC/AHIMA recognized).
- Sound knowledge of CPT, ICD-10, and HCPCS coding systems.
- Familiarity with DHA/MOH/DOH insurance regulations and payer portals (e.g., eClaimLink, Riayati, Shafafiya).
- Proficient in Microsoft Office and EMR/HIS systems.
- Excellent attention to detail and organizational skills.
- Strong communication and teamwork abilities.
