DRG Coder — High-Impact Medical Claims Specialist

Accumed; Dubai; On-site; AED 60,000 - 90,000; Full time

Job summary

Accumed is seeking an Associate Coder to apply ICD-10-CM and CPT codes to medical claims, ensuring completeness and compliance with client payer contracts. The role focuses on analyzing claims for accuracy and supporting onsite and backend processing to minimize rejections.

The ideal candidate holds a Life Sciences degree with relevant coding certification, at least two years in UAE claims processing, and knowledge of AHIMA ethics.

Qualifications

• 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

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 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.

Education

Bachelor in Life Sciences

Job description

Accumed is seeking an Associate Coder to apply ICD-10-CM and CPT codes to medical claims, ensuring completeness and compliance with client payer contracts. The role focuses on analyzing claims for accuracy and supporting onsite and backend processing to minimize rejections.

The ideal candidate holds a Life Sciences degree with relevant coding certification, at least two years in UAE claims processing, and knowledge of AHIMA ethics.