Insurance Coder

Full Job description:
We are seeking a detail-oriented and knowledgeable Insurance Coder to join our healthcare team. The ideal candidate will be responsible for accurately coding medical records and ensuring compliance with industry standards. This role requires proficiency in various coding systems and a strong understanding of medical terminology, billing processes, and electronic health record systems.

Responsibilities

1. Medical Coding and Documentation Review

• Review clinical documentation provided by physicians and healthcare providers to accurately assign ICD-10, CPT, and HCPCS codes for diagnoses, procedures, and services rendered.
• Ensure that all coding reflects the services documented and complies with local payer requirements and insurance coding standards.

2. Claims Preparation and Submission

• Prepare and process medical claims for submission to insurance companies, TPAs, and government health programs.
• Ensure each claim is accurately coded, error-free, and submitted within the payer’s timeframe to minimize claim rejections and delays.

3. Insurance Verification and Pre-Authorization Support

• Collaborate with the front desk and insurance department to verify patient coverage, benefits eligibility, and prior authorization requirements before procedures.
• Provide coding support to facilitate accurate pre-approvals.

4.Compliance and Regulatory Adherence

• Maintain strict adherence to UAE regulatory guidelines (DHA, DOH, MOHAP, etc.) and international coding standards (AAPC/AHIMA).
• Ensure all documentation and coding practices meet HIPAA and data privacy regulations.

5. Denial Management and Resubmission

• Analyze denied or rejected claims, identify coding-related reasons, and take corrective actions.
• Recode and resubmit claims promptly to ensure optimal reimbursement.

6. Revenue Cycle Optimization

• Work closely with the billing and finance teams to ensure that accurate coding contributes to maximum reimbursement and efficient cash flow.
• Identify patterns in underpayments or denials and recommend corrective strategies.

7. Internal Audits and Quality Assurance

• Conduct routine coding audits to ensure accuracy, completeness, and compliance.
• Participate in internal reviews to maintain a clean claims ratio and minimize financial risk to the centre.

8. Provider Education and Feedback

• Collaborate with physicians and nurses to educate them on documentation standards that support appropriate coding.
• Provide feedback on incomplete or ambiguous notes that may affect claim validity.

9. Reporting and Data Analytics

• Generate periodic coding, billing, and denial trend reports for management review.
• Contribute insights into service utilization, payer performance, and reimbursement trends to inform business decisions.

10. Continuous Professional Development

• Stay updated with new coding regulations, payer policies, and software updates (such as in Bitrix, eClaimLink, or DHA Shafafiya systems).
• Participate in coding workshops, training sessions, and continuing education programs to maintain certification.

Qualification:

• At least 2 years of UAE experience as an insurance coder in the clinic sector.
• Proven experience in medical coding .
• Familiarity with medical billing processes and medical collection practices is preferred.
• Strong knowledge of medical terminology to ensure accurate coding practices.
• Excellent attention to detail with the ability to work independently as well as part of a team.
• Strong analytical skills to interpret complex information accurately.
• Certification in Medical Coding (e.g., CPC, CCS) is a mandatory.

Job Type: Full-time