QUALIFICATIONS

• Bachelor’s Degree in any field, Medical preferred
• Certified Coding Specialist (CCS) accredited by the American Health Information Association (AHIMA) or
• Certified Professional Coder (CPC) accredited by the American Academy of Professional Coders (AAPC)
  Job Types: Full-time, Contrac

• Encodes all relevant, current, and documented diagnoses and procedures as performed by attending physicians utilizing the appropriate International Classification of Diseases (ICD) coding.
• Creates an abstract of all demographics, statistical and medical information from each patient record and enters the data into the coding/abstracting system.
• Understands Health Insurance Policy Terms, Coverage, Exclusions and Approval requirements as per the contractual and regulatory obligations.
• Reviews electronic statements for all prescribed diagnostics and pharmacy items along with procedures and complications as documented in the EMR, Claim Form/ operative reports.
• Assigns appropriate codes and send a request to the physician wherever required.
• Ensures Documentation is completed and specific for coding to the highest specificity/severity.
• Applies the appropriate guidelines for the assignment of principal and secondary procedures utilizing the Current Procedural Terminology (CPT) 4 procedure code when reviewing claims with the 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.
• Prepares Billed Services should be as per the Approval provided by the Insurer/Corporate.
• Reviews services are repeated within the same day and clarifications/medical necessity are sought from the Physician/Laboratory/ Medical Imaging, etc.
• Reviews Coding Edit Engine of Dubai (CEED) filtered Medical necessity/coding edits and ensures additional ICD codes are applied as required/suggested by the Insurance Coordinator.
• Estimates cost preparation received from different clinic teams for self-pay patients.
• Maintains confidentiality regarding department activities.
• Ensures physician queries are sent and reported.
• Ensures daily productivity is achieved.
• Ensures delegated insurance, corporate, and self-pay batches are closed and dispatched in line with the dispatch schedule.