Full job description
We are looking for a detail-oriented Medical Billing & Coding Specialist with a nursing background and hands-on experience in homecare facilities. The role will be responsible for medical coding, insurance billing, claim submission and resubmission, follow-up, and audit compliance. The successful candidate will also take a leadership role in Tasneef/DOH audits and ensure all required documentation and records are complete and audit-ready.
Key Responsibilities
- Review clinical documentation and accurately assign appropriate medical codes.
- Prepare and submit insurance claims in accordance with payer requirements.
- Handle claim resubmission for rejected, returned, or denied claims.
- Review claim rejections and denials, identify discrepancies, make corrections, and resubmit claims promptly.
- Follow up on submitted and outstanding claims with insurance companies and payers.
- Verify patient, insurance, authorization, and clinical information prior to claim submission.
- Ensure accurate coding using ICD-10-CM, CPT, HCPCS, and applicable coding guidelines.
- Coordinate with nurses, physicians, and administrative staff to resolve documentation and coding issues.
- Maintain accurate records of claim submissions, resubmissions, rejections, and payments.
- Monitor claims to ensure timely resolution and minimize revenue loss.
- Take the lead in Tasneef/DOH audits, coordinating audit preparation, documentation, submissions, and follow-up.
- Ensure all clinical, billing, coding, and compliance records are complete and audit-ready.
- Coordinate with relevant departments to address audit findings and implement corrective actions.
- Ensure compliance with UAE healthcare regulations, insurance policies, and payer requirements.
- Assist with internal billing, coding, and compliance audits.
Requirements:
- Bachelor’s Degree in Nursing (BSN) or equivalent nursing qualification.
- 2 to 3 years previous experience in a homecare facility is mandatory.
- Hands-on experience in medical billing, coding, insurance claims submission, and resubmission.
- Strong knowledge of ICD-10-CM, CPT, and HCPCS.
- Experience handling rejected, denied, and returned insurance claims.
- Experience or strong knowledge of Tasneef audit requirements and processes.
- Knowledge of UAE healthcare insurance and claims processes.
- Familiarity with healthcare billing systems and insurance portals.
- Strong attention to detail, leadership, coordination, and organizational skills.
- Ability to manage multiple priorities and meet strict deadlines.
Preferred
- UAE homecare experience with knowledge of DOH requirements.
- Experience with electronic claims submission and payer portals.
- Relevant medical coding or billing certification.
Work Location: In person
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