IP Medical Coder

NMC GROUP SERVICES.; Sharjah; On-site; AED 90,000 - 130,000; Full time

Job summary

NMC GROUP SERVICES in the United Arab Emirates is seeking a dedicated Medical Coder to verify ICD10 CM and CPT/HCPCS codes on UCF and discharge summaries for submission to insurance companies.

You will analyze documentation, report areas of concern, identify commonly used codes, assign codes for new services, and support clinicians and the billing team in submissions and follow-up.

The role includes training materials and ensuring compliance with company policies and final sign-off on E-claims.

Qualifications

• Bachelor's degree from an accredited college/university.
• Certification from AAPC or AHIMA is required.
• Experience or background in nursing, pharmacy, or physiotherapy is preferred.

Responsibilities

• Verify ICD10 CM and CPT/HCPCS codes on UCF/Discharge summaries for submission to insurance companies.
• Analyze documentation issues and report areas of concern in coding and claims.
• Identify commonly used ICD codes and relevant CPT codes and compile the list.
• Identify ICD codes (Diagnosis under Exclusion) and CPT codes (not billable).
• Report variations/irrelevance in CPT codes used for services/procedures.
• Assign proper CPT/HCPCS codes for newly added services/procedures.
• Report audit findings about discrepancies in claims daily.
• Coordinate with consultants for ICD/CPT code clarifications.
• Coordinate with Insurance Doctors, Billing Supervisors and Accountants for e-claim submission, resubmission, follow-up and final sign-off.

Skills

ICD10 CM

CPT Coding

HCPCS Coding

Education

Bachelor's degree

AAPC/AHIMA certification

Job description

Responsibilities

• Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF /discharge summary for submission to various insurance companies on day-to-daybasis.
• Analysis of the UCF documentation issue from time to time and providing reportsabout areas of concern in coding and the claims.
• Identifies commonly used ICD codes and relevant CPT codes and compile the list.
• Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable).
• Reports variations / irrelevance in the CPT codes used for services/procedures.
• Assigns proper CPT/ HCPCS codes for newly added services / procedures.
• Reports the audit findings about discrepancies in the claims daily.
• Be available to the Consultants about clarification regarding the ICD/ CPT codes.
• Coordinates with Insurance Doctors and Billing Supervisor/ Accountants for E claimSubmission, Resubmission, Follow Up and Final Sign off.

Claims Processing Team: Resubmission

• Coder is required to review documentation by the physicians in the UCF / E -Discharge summary and look for discrepancies between the documentationand the coded, diagnosis and selected CPT codes.
• Senior Coder required to overview the notes prepared for UCF / DischargeSummary have all the required information. In case any information is missingthey need to contact the physician and get it filled.
• Be available to the Consultants about any clarification regarding ICD/CPT codes.
• Senior Coder is required to speak to clinicians about specialty specific rejectionsand reasons for the rejections and how to avoid such rejections.
• Verifies the ICD10 CM codes and relevant CPT/HCPCS codes on the claims forsubmission to various insurance companies on day-to-day basis.
• Provides Reports/feedback about proper implementation of ICD/ CP coding.
• Provides training material and support to the cashiers/claims processors / nurseswith regards to ICD/CPT and other relevant medical coding requirements.
• Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable).
• Uploads of e-claims to the DHPO and/or any other portal necessary for claiming payments of direct billing claims.
• Coordinates with Insurance Companies medical teams for clarifications and otherday to day issues.
• Coordinates with Billing Supervisor / Accountants for E claim submission,Resubmission, Follow Up, Reconciliation and Final Sign off.
• Enters the codes in the software application.
• Adheres to the company's policies and procedures.
• Responsible for lP E-claim Submission/IP & OP Resubmission/Reconciliation

Desired Candidate Profile

Bachelor's degree from an accredited college / university. Bachelor’s degree in nursing, pharmacy, physiotherapy etc. will be preferred. Certification from AAPC / AHIMA is a must.

Employment Type

• Full-time

Company Industry

• Medical
• Medical Devices

Department / Functional Area

• Doctor
• Nurse
• Paramedics
• Medical Research

Keywords

• Revenue Cycle Management
• Coding Professional
• Clinical Coder
• CPT Coding
• Revenue Cycle Coder
• Medical Coder