Medical Coder - Inpatient

FATORAH LLC; Sharjah; On-site; AED 60,000 - 180,000; Full time

Job summary

FATORAH LLC in Sharjah, United Arab Emirates, seeks a skilled medical coder to analyze and audit inpatient/outpatient claims, ensuring accurate ICD-10-CM and CPT-4 coding according to official guidelines.

You will interact with physicians and healthcare staff to resolve documentation gaps, perform physician queries, and ensure billing compliance across payer contracts.

Qualifications

• Bachelor in Life Sciences is required.
• Certification: AAPC (CPC/COC) or AHIMA (CCS/CSSP/CCA) recognized by DHA/MOH.
• Proficiency in using coding software and EHR systems is required.

Responsibilities

• Analyze and audit claims for completeness with relation to medical information and insurance coverage.
• Communicate with physicians and providers to clarify documentation for accurate coding.
• Perform physician query process as needed.
• Review claims for accuracy and compliance before saving the bill.
• Collaborate with providers to improve medical records quality and completeness.
• Provide reports and analysis of coded data to support billing compliance and quality improvement.
• Stay updated with coding guidelines and pursue CEUs/certifications to maintain expertise.
• Understand client payer contracts to process submissions and resubmissions.
• Process claims in DC or IP scenarios as required.
• Identify and communicate coding and billing issues to supervisors.
• Follow billing rules per authorities/insurers.

Skills

Medical coding

Documentation review

Query resolution

HIPAA compliance

Education

Bachelor in Life Sciences

AAPC/CPC or AHIMA certification

Tools

Coding software

EHR systems

Claim submission tools

Job description

Responsibilities

• Analyzing and auditing of claims for completeness with relation to medical information and insurance coverage for services rendered.


• Communicate with physicians and other healthcare providers to clarify ambiguous or incomplete documentation to ensure accurate coding.


• Physician Query Process as and when required.


• Scrutinize claims for accuracy, completeness and compliance with coding and billing standards before saving the bill.


• Collaborate with healthcare providers and clinical documentation improvement specialists to enhance the quality and completeness of medical records.


• Provide reports and analysis of coded data to support billing compliance and quality improvement efforts.


• Stay up to date with changes in coding guidelines and regulations and pursue ongoing education CEUs and certifications to maintain expertise in Inpatient coding.


• 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 DC or IP scenario.


• Analyze and communicate coding and billing issues of the provider to the supervisors.


• Have complete knowledge of billing guidelines of the provider and payer.


• 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.


• 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.


• To undertake any additional tasks assigned by the line manager in accordance with operational requirements.


• Follow the correct billing Rules as per the standard set by Authorities Insurance companies.

Qualifications

• Bachelor in Life Sciences.


• Most relevant coding certification from AAPC (COC, CPC, CIC) or AHIMA (CCS, CSSP, CCA) as accepted by the DHA/MOH.


• Proficiency in using coding software and Electronic Health Record (EHR) systems.