A Medical Coder with e-claims experience is responsible for accurately translating patient information, diagnoses, procedures, and treatments into standardized medical codes, ensuring compliance with UAE healthcare regulations, insurance requirements, and e-claims submissions. The role requires thorough knowledge of coding systems like ICD-10-CM, CPT, and HCPCS, along with hands-on experience in managing electronic claims (e-claims) processes in the UAE healthcare industry.
Key Responsibilities:
Medical Coding:
Accurately assign and review medical codes for diagnoses, procedures, and services using coding standards (ICD-10-CM, CPT, and HCPCS).
Ensure proper coding for various specialties, including inpatient, outpatient, and physician services.
Verify and update medical records to ensure all required information is captured.
E-Claims Management:
Process and submit electronic claims to insurance companies and healthcare payers.
Review and resolve claim rejections, denials, and discrepancies.
Work closely with insurance companies to ensure timely payments and compliance with UAE insurance regulations.
Use e-claims software (e.g., DHPO, Tashafi, or others) to manage claim submissions, status tracking, and resubmissions.
Compliance & Quality Assurance:
Stay updated with UAE medical coding guidelines, insurance policies, and regulatory requirements.
Ensure compliance with DHA, HAAD, and MOH regulations for coding and billing.
Conduct regular audits of medical coding and e-claim submissions to ensure accuracy.
Identify and resolve coding errors, improve documentation accuracy, and minimize the risk of fraud or incorrect claims.
Collaboration & Communication:
Work closely with physicians, nurses, billing departments, and other healthcare professionals to clarify diagnosis and documentation issues.
Train and educate staff on coding updates, billing processes, and claim management best practices.
Requirements:
Educational Qualifications:
Diploma or Bachelor’s Degree in Health Information Management, Medical Coding, or a related field.
Certified Professional Coder (CPC) or equivalent certification (e.g., AAPC, AHIMA).
Experience:
Minimum 2-3 years of medical coding experience, with a focus on UAE healthcare systems.
Proven experience with electronic claims submission and management, Dubai Experience is mandatory
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