Job Purpose:
The Medical Coder & Submission Officer is responsible for accurately coding medical services, preparing insurance claims, and ensuring timely submission and approval of patient cases with insurance companies and regulatory authorities. This role ensures compliance with DHA/DOH/HAAD guidelines and supports the financial cycle of the home care services.
Key Responsibilities:
- Medical Coding
- Assign appropriate ICD-10, CPT, and other relevant codes to patient diagnoses, treatments, and procedures.
- Ensure coding accuracy in line with DHA/DOH guidelines and payer requirements.
- Review medical records, face-to-face reports, and clinical documentation for completeness and compliance.
- Claims Preparation & Submission
- Prepare insurance claims and submit them to payers through the appropriate portals (e.g., Thiqa, Daman, etc.).
- Track claim status and ensure timely approvals for patient admissions and services.
- Follow up on pending claims, rejections, and denials, coordinating with physicians and nursing staff for supporting documents.
- Coordination & Documentation
- Work closely with the Quality and KPI department to ensure compliance with insurance and regulatory requirements.
- Coordinate with physicians, nurses, and patient families to collect missing documents or clarifications.
- Maintain accurate patient records, coding logs, and submission reports.
- Compliance & Audit Support
- Ensure adherence to all insurance regulations, DHA/DOH policies, and internal standards.
- Support internal and external audits by providing accurate coding and submission records.
- Stay updated with changes in medical coding guidelines and insurance requirements.
Qualifications & Requirements:
- Bachelor’s Degree in a healthcare-related field or equivalent.
- Certified Medical Coder (CPC, CCS, or equivalent certification) preferred.
- Minimum 2 years of experience in medical coding and claim submissions (home care experience preferred).
- Strong knowledge of ICD-10, CPT, and insurance billing procedures in the UAE healthcare system.
- Proficiency in claim submission portals (e.g., Thiqa, Daman, NAS, etc.).
- Excellent communication, problem-solving, and documentation skills.
Job Type: Full-time
Pay: From AED5,000.00 per month
Application Question(s):
- Are you available to join Immediately ?
Education:
- Bachelor's (Required)
Experience:
- Home Care: 2 years (Required)
Location:
- Al-Ayn (Required)