RCM Administrator

Jobsatdubai; Sharjah; On-site; AED 89,000 - 134,000; Full time

Job summary

Jobsatdubai is seeking an RCM Administrator in the UAE to manage claims submission and coding accuracy. You will verify ICD-10 CM and CPT/HCPCS codes on submissions, and coordinate with doctors and insurers to resolve discrepancies.

Responsibilities include reviewing documentation, auditing coding practices, and preparing reports for the billing team. AAPC/AHIMA certification is preferred and a bachelor’s degree is required.

Qualifications

• Bachelor’s degree in nursing, pharmacy, physiotherapy or related field; AAPC/AHIMA certification preferred.
• Experience with ICD-10-CM and CPT coding for medical claims is essential.

Responsibilities

• Verifies ICD-10 CM and CPT/HCPCS codes on claims for submission.
• Analyzes documentation discrepancies and provides reports on coding issues.
• Uploads E-claims and coordinates with insurers and billing team for resubmission.
• Enters codes into software and ensures accuracy and compliance.

Skills

ICD-10 CM coding

CPT coding

E-claim submission

Auditing and reporting

Education

Bachelor’s degree

Job description

RCM Administrator

Job Description

• Manages Claims Submission by checking accuracy of CPT and ICD coded invoices. Rectifies errors in billing in coordination with the doctors.

Responsibilities

Claims Processing Team: Submission

•Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF / discharge summary for submission to various insurance companies on day-to-day basis.
•Analysis of the UCF documentation issue from time to time and providing reports about 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 claim Submission, 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 summaryand look for discrepancies between the documentation and the coded, diagnosis and selected CPT codes.
•Senior Coder required to overview the notes prepared for UCF / Discharge Summary have all the required information. In case any information is missing they 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 rejections and reasons for the rejections and how to avoid such rejections

Verifies the ICD10 CM codes and relevant CPT/HCPCS codes on the claims for submission 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 / nurses with 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 other day 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

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.