Medical Coder - Medical Coding Documentation

سانتكتشور لحلول البرمجيات الصحية; Riyadh; On-site; SAR 120,000 - 150,000; Full time

Job summary

A healthcare software solutions company in Saudi Arabia is looking for an experienced Medical Coder to handle clinical coding and ensure accurate implementation of coding principles. Responsibilities include acting as a subject matter expert in clinical coding, managing coding integrity, and preparation of market analysis. The ideal candidate should have 2-5 years of experience in medical coding, proficiency in healthcare information systems, and strong communication skills. Knowledge of local regulations is crucial for success in this role.

Qualifications

• Minimum 2-5 years experience as a Medical Coder in Saudi Arabia.
• Experience with private healthcare insurance sector.
• Familiarity with KSA local market regulations like CCHI.

Responsibilities

• Act as a subject matter expert for clinical coding queries.
• Manage integrity of the Rules engine for accurate coding.
• Prepare crosswalks analysing local market practice.

Skills

Medical Billing knowledge

Excellent verbal/written communication

Leadership skills

Proficiency in Healthcare Information Systems

Bi-lingual Arabic/English

Education

Recognised Professional Certification in Medical Coding

Medical training as Doctor/Nurse/Pharmacist

Tools

Microsoft Office

Job description

Responsible for reviewing and analysing market payer and regulator protocols and review medical records in order to abstract relevant data to support the creation of rules to ensure appropriate codes are assigned in accordance with the Saudi clinical coding system and standards. THYNK Rules will support billing integrity and provide best practice support through working closely with payers, regulators, and healthcare providers revenue cycle departments to resolve coding/billing issues, Investigating and resolving issues and incidents leading to incompliance with regulatory policies or denials with payers in the market of Saudi Arabia.

Primary Responsibilities

• To act as a subject matter expert within the KSA Rules unit for all matters related to clinical coding queries under the Saudi Billing System, CCHI Coding Standards and Australian Coding Standards (ACS)
• Manages integrity of Rules engine by defining the correct implementation of the
• Ensures accurate coding as specified by established coding principles and guidelines.
• Translation of region-based coding guidelines and local market practice into rule alerts by analysing ICD-10-AM (10th edition), ACHI and SBS codes (service codes) and drugs standards codes (HUMAN DRUGS LIST)
• Email correspondence and troubleshoot with different departments for rule requests, suggestions, and queries.
• Preparation of crosswalks analysing local market practice and Remittance advices.
• Timely maintenance and scrubbing of engine as per coding and local market practice

Job Requirements

• Minimum 2-5 years experience as a Medical Coder in the Kingdom of Saudi Arabia
• Medical Billing knowledge within private healthcare insurance sector required
• Recognised Professional Certification in Medical Coding highly desirable
• Candidate with past working experience with insurance payers background will be preferred
• Should be well versed KSA local market regulations like CCHI, Health Council and SEBAHI
• Excellent verbal/written communication and leadership skills
• Proficiency in Healthcare Information Systems and Microsoft Office (Word, Excel, PowerPoint, etc.)
• Bi-lingual Arabic/English preferred
• Medical training as Doctor/Nurse/Pharmacist is highly desirable