Specialist - Submission

Sheikh Shakhbout Medical City; Abu Dhabi; On-site; AED 120,000 - 180,000; Full time

Job summary

Sheikh Shakhbout Medical City in Abu Dhabi seeks a Clinical Coder to review medical records and translate documentation into accurate diagnostic and procedure codes. You will ensure complete data for coding and support pre-authorization coding needs.

The role requires expertise in E/M coding, coding guidelines, and payer compliance, with collaboration across clinicians, coders, and billing teams to optimize revenue integrity.

Qualifications

• Bachelor's degree in Health Information Management or related field with 3 years of healthcare experience.
• Master's degree or equivalent in Health Information Management or related field preferred.
• Diploma in a relevant field may be considered with appropriate experience.

Responsibilities

• Review clinical information from medical records and translate into diagnostic and operative procedure codes.
• Review patient records to ensure data availability for coding.
• Abstract and assign relevant codes for medical records.
• Assign codes for pre-authorization purposes.
• Review and assign E/M codes based on clinician documentation to ensure proper reimbursement.
• Query physicians when documentation is unclear or codes are not straightforward.
• Request additional documentation from departments or clinics as needed.
• Ensure coding follows established principles and guidelines.
• Allocate codes from indexing systems and prepare coding summaries.
• Audit medical claims for accuracy and regulatory compliance.
• Identify billing discrepancies and support process improvements.
• Assist with medical record preparation for QA and audits.
• Report coding defaulters per facility policy.
• Confirm codes for resubmissions or denials due to coding errors.
• Collaborate with coders, billers, physicians and operations teams.

Skills

Medical coding

Clinical documentation

Auditing

Querying physicians

Payer/compliance

Collaboration

Education

Bachelor's degree in Health Information Management or related field

Diploma in Health Information Management or related field

Master's degree in Health Information Management or related field

Job description

Responsibilities

• Responsible for reviewing abstracting and analyzing clinical information from medical records and relevant documents translating the information into diagnostic and operative procedure codes in accordance with the clinical coding system
• Reviewing and analyzing patient medical records to ensure all applicable patient data is available for coding
• Abstracting pertinent information from patient records and assigning the relevant codes
• Assigning appropriate codes for pre-authorization purpose
• Reviewing and assigning appropriate E amp M s codes based on Clinician s documentation available in medical records to ensure proper re-imbursement for the facility
• Querying physicians when code assignments are not straightforward or documentation in the record is inadequate ambiguous or unclear for coding purposes
• Contacting the department section or clinic and obtaining copies of additional documentation
• Ensuring accurate coding and sequencing as specified by established coding principles and guidelines following the clinical coding system
• Allocating the appropriate and specific codes from the indexing system and assigning the codes for completing coding summary of the medical records
• Reviewing and auditing medical claims to ensure accuracy compliance with payer guidelines coding and billing standards and organizational policies
• This role involves identifying billing discrepancies preventing revenue leakage improving claim quality and supporting continuous process improvement
• Assisting with the preparation of medical records for the quality assurance and medical audit purposes by providing the coding data Validating that encoded information is reported with most accurate information Regulatory requirements Timely analysis notification and completion of medical records as per the facilities chart completion policies and procedures regulatory and accreditation standards
• Reporting defaulters to the Senior Clinical Coding Officer for further actions as per the facilities policy and procedures
• Reviewing and confirmation of assigned codes for resubmissions amp denials for re-imbursement needs pertaining to coding errors
• Collaborate with coders billers physicians and operational teams to resolve claim-related issues
• Staying current with the clinical coding system through publications seminars workshops continuing education programs and other changes in the insurance industry
• Ensuring that coding is consistent with all recognized standards Complying consistently with facility policies procedures and practices and ensuring alignment with SEHA facilities policies
• Completing and maintaining regulatory requirements including licensure and certification and other mandatory training within established time frames

Qualifications

• Required Bachelor Degree in Health Information Management or relevant field with or Diploma with 3 years of additional experience in Healthcare
• Desired Master degree or equivalent in Health Information Management or relevant field
• Desired Diploma in relevant field
• Bachelor Degree in Health Information Management or relevant field with or Diploma with 3 years of additional experience in HealthcareMaster degree or equivalent in Health Information Management or relevant fieldDiploma in relevant field