• Ensure appropriate selection of principal diagnosis, qualifying secondary diagnosis, impacting procedures and others services which is relevant for submission and reimbursement.
• Effective physician query process prior to code assignment to obtain greatest possible diagnostic specificity and clinical documentation to accurately reflect the patient's condition.
• Consistently maintain quality and productivity standards and achieve the productivity target and quality targets
• Ensures to reduce rejections and get the claim paid at the initial submission of claims
• Perform other related duties incidental to the work described herein
• Identify documentation deficiencies and query physician for clarification and additional documentation prior to code assignment
• Adhere to the DHA Claims and Adjudication rules and coding guidelines
• Assign codes for pre-authorization process and effective response to payer queries coordinating with clinical team
• Ensures to reduce rejections and get the claim paid at the initial submission of claims.
• Perform other related duties incidental to the work described herein.

Education, Experience, and skills needed

• Education: Degree in any related field preferably medical or life science background. CCS (AHIMA) or CPC (AAPC) certification is mandatory
• Minimum of one-two (1-2) years coding experience in any setting i.e. Payer, hospital, clinic, or other related healthcare field preferably in UAE is required
• Willingness to work in different shifts
• Willingness to work from different facility
• Basic knowledge in medical record review to abstract information required to support accurate coding
• Good skill in assigning accurate ICD-10-CM, CPT, DRG, HCPCS and other service codes for diagnosis and procedures performed in the OP/ER/IP setting.
• Excellent interpersonal skills while interacting with physicians, nurses and other staffs
• Knowledge on Diagnosis related grouping
• Aware of current trends related to medical necessity, DRG and DHA and Adjudication rules and coding guidelines
• Proficiency in the use of PCs and MS Office suite
• Excellent in communication skills.
• Good understanding of pre-authorization process and payer adjudication guidelines related to DHA or HAAD
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