OP Medical Coder

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

Job summary

NMC seeks a skilled Medical Coder to verify ICD-10-CM and CPT/HCPCS codes on UCF and discharge summaries for insurer submission. You will analyze documentation, prepare e-claims, and coordinate with doctors and billing teams to ensure accurate coding and timely resubmissions.

Bachelor's degree is required; AHIMA or AAPC certification is mandatory. Strong knowledge of ICD-10-CM and CPT, plus auditing experience, is valued.

Qualifications

• Bachelor's degree from an accredited college/university.
• AAPC/AHIMA certification is mandatory.
• Experience in medical coding and claims processing.
• Knowledge of ICD-10-CM and CPT coding.

Responsibilities

• Verify ICD-10-CM and CPT/HCPCS codes on UCF and discharge summaries.
• Submit e-claims and coordinate with insurers.
• Identify non-billable codes and discrepancies.
• Provide training materials and support to staff.
• Collaborate with doctors and billing for resubmissions and follow-up.
• Prepare audit reports and highlight coding concerns.
• Ensure compliance with company policies.

Skills

ICD-10-CM coding

CPT/HCPCS coding

Auditing

Documentation review

Education

Bachelor's degree

AAPC/AHIMA certification

Tools

E-claim portal

Coding software

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.
• Uploads OP E-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

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• 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/ReconciliationREPORTING STRUCTURE

Qualifications:

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.