Medical Coder /Claims Audit

We are looking for Medical Coder /Claims Audit who is highly proficient in computer software and Microsoft applications, holding license/certification in AAPC/AHIMA with wide knowledge and understanding in HAAD / DHA / IA guidelines, rules & standards.

Educational Qualification:

• Graduate in Nursing/ MBBS/BAMS /BHMS + license/certification in AAPC/AHIMA

Additional Requirements:

• Minimum 3 - 5 years’ experience in medical coding or pre-approval department in a health care (TPA /Insurance) industry
• The candidate should have adequate knowledge about regulatory guidelines
• Knowledge in DRG guidelines
• Knowledge and practical experience in Provider –Audit will be an added advantage
• Immediate Joining, UAE Driving License

Job Expertise:

• Ensure the claims audit and recovery process are in compliance with PD 01/2019 &HAAD/SD/HSFR/0.9 and adherence to timelines mentioned in the circular.
• Lead the provider audit team, conduct the onsite/offsite audit, and prepare audit findings report, communications with provider, and documentation and closure actions as per authority requirement.
• Maintain the provider audit/recon communication documentations as per authority requirement.
• To coordinate with Claims, Network and Finance team for recovery payment related communications and collection for the same.
• Identifies discrepancies, potential quality of care, billing issues and analyzes, recommends and facilitates plan of action to correct discrepancies and prevent future coding errors.

Remuneration:

• At par with best in industry

No. of Vacancy:

• 02 Nos

Work Location: In person