Coding Associates (IP)

Accumed; Dubai; On-site; AED 80,000 - 100,000; Full time

Job summary

A healthcare services company in Dubai is seeking an Associate Coder to ensure accurate coding of medical services and claims. The ideal candidate will hold a Bachelor's in Life Sciences and relevant coding certification, with a minimum of 2 years of experience in insurance claims processing within the UAE. Responsibilities include analyzing claims for medical accuracy and applying appropriate codes according to established guidelines. Experience in DRG coding is a plus. The role emphasizes high-quality processing to meet client KPIs.

Qualifications

• 2+ years of relevant experience in insurance claims processing.
• Experience with DRG coding is advantageous.
• Understanding of coding guidelines and payer contracts.

Responsibilities

• Analyze and audit claims for medical information completeness.
• Apply relevant code sets considering trends for denials.
• Process claims in both OP and IP scenarios.
• Review documentation for completeness and coding accuracy.
• Observe AHIMA code of ethics in coding.

Skills

Medical coding

Claims processing

Attention to detail

Education

Bachelor in Life Sciences

Relevant coding certification

Job description

Medical Coding (IP) is the process where the medical record and claim documentation are checked and medical diagnostics, treatments and procedures (medical services) are converted to universal alphanumeric codes. This is one of the intermediate steps in processing claims. These codes form part of data collection which is used in research, funding and healthcare planning

The Associate Coder is responsible for applying the relevant coding to the claims based on the individual providers manual and as per the coding rules governing the specific compliance in relation to coding guidelines for the specific geographical area.

Primary Responsibilities:

• Analyzing and auditing of claims for completeness with relation to medical information and insurance coverage for services rendered.
• Applying the relevant code sets, keeping in mind the trends for denials and non-payments in relation to detailed data needed to describe and notify services as rendered within the Insurance scenario.
• Understand the individual client payer contracts so as to be able to process claims in submission and resubmission based on the same.
• Be able to process claims either in OP or IP scenario.
• Analyze and communicate coding and billing issue of the provider to the supervisors.
• Have complete knowledge of billing guidelines of the provider and payer.
• To assist with documentation review and raise queries on completeness of EMR.
• The Coder must undertake a thorough review of applicable documentation to assess the documentation requirement and determine the appropriate ICD-10-CM and/or CPT-4/USCLS codes to be reported, in conjunction with the applicable version of Official Guidelines.
• Must observe AHIMA code of ethics while assigning relevant code sets.

Job Requirements:

• Bachelor in Life Sciences.
• Most relevant coding certification with updated membership to a body as accepted by the geographical governance area.
• Relevant experience of at least 2 years in insurance claims.
• A minimum of 2 years' experience and good knowledge of claims processing within UAE.
• Experience in DRG coding will be an added advantage.

Key Performance Indicators (KPI's)

• Meeting the set targets for processing the claims.
• Meet the client set KPI for initial Rejection rates.
• Maintain the 95% quality for processing claims.