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op medical coder

ip medical coder

NMC Health plc

<div>Ensures proper coding of documents in accordance with the regulator&rsquo; coding guidelines and regulations.</div>
 <div><ul><li>Checks and sequences the most accurate ICD-9/ICD-10-CM/CPT/HCPCS/DRG/other codes for diagnoses and procedures based on documented information, ensuring final diagnoses and operative procedures stated by the physician are valid and complete.
</li><li>Abstracts necessary information from health records to identify secondary complications and co-morbid conditions.
</li><li>Evaluates records for documentation consistency and adequacy; ensures the final diagnosis reflects the care provided; computes and assigns the correct DRG for all inpatient cases.
</li><li>Provides training and guidance to other coders/medical records technicians, including updates on new coding rules and regulations.
</li><li>Analyzes physicians&rsquo; documentation to ensure appropriate E&amp;M levels and correct CPT codes are assigned.
</li><li>Ensures coding compliance with HAAD guidelines and regulations.
</li><li>Provides feedback to doctors regarding coding errors or oversights.
</li><li>Keeps updated with the latest coding versions and HAAD coding directives.
</li><li>Performs miscellaneous job-related duties as assigned.
</li><li>Performs any other tasks assigned by the HOD within the scope of the job title.
</li><li>Complies with all OSH and infection control policies, standards, and procedures; cooperates with hospital management to meet compliance requirements.
</li><li>Works in accordance with documented OSH procedures and instructions.
</li><li>Is familiar with emergency and evacuation procedures.
</li><li>Reports OSH hazards, incidents, near misses, and assists with risk assessments and incident reports.
</li><li>Complies with waste-management procedures and policies.
</li><li>Attends applicable OSH/Infection Control training programs, mock drills, and awareness programs.
</li><li>Uses appropriate personal protective equipment (PPE) and safety systems as required.</li></ul></div>
 <div><ul><li>Bachelor&rsquo;s Degree in Allied Health Sciences or a related field, with at least two (2) years of coding experience.
</li><li>Valid Certified Coding Associate (CCA) certification from AHIMA or Certified Professional Coder (CPC) certification from AAPC.
</li><li>Computer literacy, including proficiency in MS Office.
</li><li>Excellent command of oral and written English.
</li><li>Performance Criteria:
<ul><li>Achievement of core objectives in alignment with management and stakeholder expectations.
</li><li>Ability to work constructively and interact professionally with colleagues and other stakeholders.
</li><li>Ability to coordinate multiple tasks, adapt to changing priorities, and meet deadlines.</li></ul></li></ul></div>

IP Medical Coder

<div>1.1 The incumbent checks and sequences the most accurate ICD-9/ ICD10- CM/CPT/HCPCS/DRG/Other codes for diagnoses and procedures for documented information. Assures the final diagnoses and operative procedures as stated by the physician are valid and complete.
1.2 Abstracts all necessary information from health records to identify secondary complications and co-morbid conditions.
1.3 Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Computes and gives the correct DRG coding all inpatients cases.
1.4 Providing training and guiding other coders / Medical Records Technicians in coding, updating them with new coding rules and regulations as and when it is necessary. 
 
1.5 Analyzes doctors&rsquo; documentation to assure the appropriate Evaluation &amp;
 
Management (E &amp; M) levels are assigned using the correct CPT code.
1.6 Ensures coding is as per DOH guidelines and regulations.
1.7 Provides feedback to Doctors regarding coding errors or oversights.
1.8 Constantly updates to the latest coding versions and DOH coding directives.</div>
 <div><ul><li>Check and assign accurate ICD-9/ICD-10-CM, CPT, HCPCS, DRG, and other relevant codes for diagnoses and procedures based on documented information, ensuring final diagnoses and operative procedures are valid and complete.
</li><li>Abstract essential information from health records to identify secondary complications and co-morbid conditions.
</li><li>Evaluate medical records for documentation accuracy, consistency, and adequacy, ensuring the final diagnosis reflects the treatment provided; compute and assign correct DRG codes for all inpatient cases.
</li><li>Provide training, guidance, and support to coders and Medical Records Technicians, including updates on new coding rules and regulations.
</li><li>Analyze physicians&rsquo; documentation to ensure appropriate Evaluation &amp; Management (E&amp;M) levels are assigned using the correct CPT codes.
</li><li>Ensure all coding practices adhere to DOH guidelines and regulatory standards.
</li><li>Provide feedback to physicians regarding coding errors, discrepancies, or areas for improvement.
</li><li>Stay updated on the latest coding versions, DOH directives, and industry coding updates.</li></ul></div>
 <div>A graduate of Bachelor&rsquo;s Degree in Allied Health Sciences or related areas with at least two (2) years of coding experience with valid Certified Coding Associate (CCA) certification from American Health Information Management Association (AHIMA) or Certified Professional Coder (CPC) certification from American Academy of Professional Coders (AAPC).
Preferably one year experience of coding medical claims.</div>

OP Medical Coder

DANA CATERING

We are seeking a senior, results-driven Insurance Claims &amp; Revenue Cycle Manager with deep expertise in Daman insurance, Abu Dhabi claim workflows, and end-to-end revenue cycle control.This role carries full accountability for reducing insurance rejections, accelerating collections, and ensuring timely reconciliation of all insurance receivables in compliance with DOH regulations.Key Responsibilities:1. Insurance Claims Rejection Reduction:<ul><li>Lead and control the entire insurance claims lifecycle (pre-authorization, submission, resubmission, appeal).</li><li>Reduce initial insurance claim rejections to &le; 3% of total claims within 45 days.</li><li>Actively manage and correct rejection causes related to:</li><li>Physicians (clinical documentation &amp; coding alignment)</li><li>Medical coders (CPT / ICD / DRG accuracy)</li><li>Reception &amp; front desk errors (eligibility, approvals, data capture)</li><li>Implement preventive rejection controls (pre-billing audits, checklist enforcement).</li></ul>2. Daman-Focused Claims Management:<ul><li>Handle Daman Enhanced, Basic, and Thiqa and other insurances workflows with full mastery.</li><li>Maintain up-to-date knowledge of Daman/insurance companies policies, circulars, rules, and exclusions in the Emirate of Abu Dhabi.</li><li>Ensure accurate compliance with clinical pathways, tariff rules, and submission timelines.</li></ul>3. Insurance Reconciliation &amp; Collections:<ul><li>Achieve full reconciliation of all insurance claims within 90 days of submission.</li><li>Track outstanding receivables, mismatches, underpayments, and denials.</li><li>Ensure accurate follow-ups, resubmissions, and justifications until closure.</li><li>Maintain a clean aging report with clear accountability and resolution tracking.</li></ul>4. Revenue Cycle Control &amp; Reporting:<ul><li>Own insurance KPIs including:</li><li>Rejection ratio</li><li>Collection turnaround time</li><li>Claims aging (30 / 60 / 90+)</li><li>Recovery percentage</li><li>Produce Daily, weekly and monthly performance reports for management.</li><li>Identify revenue leakage and implement corrective actions immediately.</li></ul>5. Cross-Department Leadership:<ul><li>Work closely with:</li><li>Doctors (clinical documentation quality)</li><li>Medical coders</li><li>Reception and front office teams</li><li>Finance and operations</li><li>Train and enforce best practices across departments to maintain rejection thresholds.</li><li>Act as the final authority on insurance disputes and escalation matters.</li></ul>Key Performance Indicators (KPIs):The following KPIs are tied directly to compensation growth:<ul><li>Insurance Reconciliation KPI</li><li>100% reconciliation of insurance claims within 90 days of submission.</li><li>Claims Rejection KPI</li><li>Reduce and maintain initial rejection rate at or below 3% of total claims within 45 days, including:</li><li>Doctor-related rejections</li><li>Coder-related rejections</li><li>Reception/front desk rejections</li></ul>Mandatory Qualifications:<ul><li>Minimum 10 years of insurance claims experience in Abu Dhabi</li><li>Strong, hands-on experience with Insurance claims</li><li>Deep understanding of:</li><li>DOH regulations</li><li>ICD-10, CPT, DRG coding workflows</li><li>Proven track record of reducing rejection ratios and accelerating collections</li></ul>This Role Is Not Suitable For:<ul><li>Junior or mid-level insurance staff</li><li>Candidates without Abu Dhabi insurance experience</li></ul>Job Type: Full-timePay: AED7,000.00 - AED8,000.00 per month

Revenue Manager

<div>Ensures work is performed within the required technical and patient confidentiality standards 
3.2 Promote quality and cost-effective interventions and outcomes 
3.3 Record cases information, complete accurately all necessary forms and produce statistical reports 
3.4 Develop effective working relations and provide feedback to administrative, medical and RCM team throughout the entire case management process 
3.5 Handling case assignments, draft service plans, review case progress and determine case closure 
3.6 Evaluating healthcare treatments and negotiating the most cost effective options available to manage DRG
3.7 Assist in timely discharge 
3.8 Evaluate the rigor of documentation and code assignment (during IP stay with doctors) to ensure fair reimbursement
3.9 Evaluate and develop training sections to avoid rejections 
3.10 Rejection analysis, management and coordination with responsible departments in developing collaborating strategies. 
3.11 In coordination with the Revenue Cycle Manager implements standard operating procedures and guidelines for the coding section. 
3. 12 Provides leadership and guidance to staff when required to address issues or concerns. 
3. 13 Train the new and existing coding staff on coding expectations and meeting goals related to both quality and productivity which helps in upgrading the services&rsquo; codes and subsequently higher revenue. 
3. 14 Act as a mentor and resource to Coding Team members. 
3. 15 Monitor tasks to improve billing practices and increase revenue 
3. 16 Audit both IP and OP charts on a regular basis and share audit results with the team members and ensure that performance improvement plans are implemented. Submit audit report on a monthly basis to the corporate audit team
3. 17 Attends Training and Meetings to receive updated billing and coding information 
3. 18 Assess /determines staff level and coordinates with Revenue Cycle Manager to meet defined KPIs. 
3.19 Reports all staffing deficiencies and disciplinary issues to Revenue Cycle Manager by providing all documentation to ensure proper review and action. 
3.20 Ensures adherence to objectives, operating policies and procedures and strategic action plans for achieving goals. 
3.21 Provides leadership and motivation by addressing clear expectations, communicates specific performance feedback to Revenue Cycle Manager to ensure timely and thorough performance reviews using internal measurement/monitoring standards. 
3.23 Communicates coaching needs for staff who failed to perform and deliver the prescribed and committed level of performance output and standards to the Revenue Cycle Manager.</div>
 <div>Ensures work is performed within the required technical and patient confidentiality standards 
3.2 Promote quality and cost-effective interventions and outcomes 
3.3 Record cases information, complete accurately all necessary forms and produce statistical reports 
3.4 Develop effective working relations and provide feedback to administrative, medical and RCM team throughout the entire case management process 
3.5 Handling case assignments, draft service plans, review case progress and determine case closure 
3.6 Evaluating healthcare treatments and negotiating the most cost effective options available to manage DRG
3.7 Assist in timely discharge 
3.8 Evaluate the rigor of documentation and code assignment (during IP stay with doctors) to ensure fair reimbursement
3.9 Evaluate and develop training sections to avoid rejections 
3.10 Rejection analysis, management and coordination with responsible departments in developing collaborating strategies. 
3.11 In coordination with the Revenue Cycle Manager implements standard operating procedures and guidelines for the coding section. 
3. 12 Provides leadership and guidance to staff when required to address issues or concerns. 
3. 13 Train the new and existing coding staff on coding expectations and meeting goals related to both quality and productivity which helps in upgrading the services&rsquo; codes and subsequently higher revenue. 
3. 14 Act as a mentor and resource to Coding Team members. 
3. 15 Monitor tasks to improve billing practices and increase revenue 
3. 16 Audit both IP and OP charts on a regular basis and share audit results with the team members and ensure that performance improvement plans are implemented. Submit audit report on a monthly basis to the corporate audit team
3. 17 Attends Training and Meetings to receive updated billing and coding information 
3. 18 Assess /determines staff level and coordinates with Revenue Cycle Manager to meet defined KPIs. 
3.19 Reports all staffing deficiencies and disciplinary issues to Revenue Cycle Manager by providing all documentation to ensure proper review and action. 
3.20 Ensures adherence to objectives, operating policies and procedures and strategic action plans for achieving goals. 
3.21 Provides leadership and motivation by addressing clear expectations, communicates specific performance feedback to Revenue Cycle Manager to ensure timely and thorough performance reviews using internal measurement/monitoring standards. 
3.23 Communicates coaching needs for staff who failed to perform and deliver the prescribed and committed level of performance output and standards to the Revenue Cycle Manager.</div>
 <div>Bachelor or any other degree in Paramedical with coding certification from AAPC/CPC/AHIMA with DRG coding and EMR knowledge preferred. 
5.2 Minimum 5 years of experience using the ICD and CPT coding and must have proven track record in supervising the day- to-day functions of Medical coding Team 
5.3 Strong supervisory competencies in the areas of leadership and team development, coaching, mentoring and situational assessment skills. 
5.4 Knowledge in using computer and related software applications and proficient in using MS office programs. 
5.5 Supervisor judgment and decision making skills 
5.6 Communication analytical and interpersonal skills as applied to interaction with co-workers, supervisor and customers and capability to interact with all levels in the organization. 
5.7 Strong ethics and high level of personal and professional integrity.</div>

OP Medical Coder Team Lead

W R S OFFICE AUTOMATION TRADING LLC OPC

Job Title: Printer Technician / Office Automation TechnicianLocation: UAE Industry: Office Automation / IT Services Employment Type: Full-timeJob DescriptionWe are looking for a skilled Printer Technician to install, maintain, and repair office automation equipment. The ideal candidate should have hands-on experience with printers, copiers, and multifunction devices and be capable of troubleshooting hardware and software issues efficiently.Key Responsibilities<ul><li>Install, configure, and maintain printers, copiers, scanners, and MFP machines</li><li>Diagnose and repair hardware and software issues</li><li>Perform preventive maintenance and service calls at client sites</li><li>Handle toner, spare parts replacement, and consumables management</li><li>Provide technical support and training to clients when required</li><li>Coordinate with the service team and update job/service reports</li><li>Ensure customer satisfaction and timely issue resolution</li></ul>Requirements<ul><li>Proven experience as a Printer / Copier Technician</li><li>Strong troubleshooting and problem-solving skills</li><li>Knowledge of major brands (Ricoh, Canon, HP, Xerox, Kyocera, Konica Minolta, etc.)</li><li>Basic networking knowledge (IP configuration, scanning, drivers)</li><li>Valid UAE driving license (preferred)</li><li>Ability to work independently and under pressure</li></ul>Preferred Qualifications<ul><li>1&ndash;3 years UAE experience in office automation</li><li>Diploma or IT/Technical certification is an advantage</li></ul>Salary &amp; Benefits<ul><li>Competitive salary</li><li>Visa, medical insurance, and other benefits as per UAE labor law</li></ul>Job Type: Full-time

Printer technician

<div>2.1 Apply medical knowledge and best insurance practice while reviewing and verifying the Pre Approval requests (OP/ IP) received from different departments to obtain authorizations as required by insurance companies dependent upon the plan coverage for all Insurance patients. Ensure that the details of the Pre Authorization Requests are in line with the regulators&rsquo; standards especially the claim adjudication Rules and Business Rules.
 
2.2 Handling the rejected pre authorization and get required justification from the treating doctor to resend it to Insurance Company and obtain the approval.
 
2.3 Prepares reports of daily activity as requested for management and assists management in month end reporting as requested.</div>
 <div><ul><li>Evaluate pre-approval requests for medical necessity based on the provided medical data and accurately code the service description according to accepted medical coding rules, medical guidelines, and policy schedule of benefits.
</li><li>Respond to Insurance/TPA queries and coordinate with the concerned departments without delay.
</li><li>Receive, evaluate, and escalate second-opinion cases and case management as required.
</li><li>Perform night shift duties and work on public holidays as per the duty roster.
</li><li>Prepare daily activity reports as requested by management and assist in monthly reports when needed.
</li><li>Handle the auditing process, arrange required documents, and coordinate with coders to support external auditors.
</li><li>Attend meetings and presentations.
</li><li>Train Front Office, Receptionists, and Nurses, ensuring they remain updated on insurance details.
</li><li>Prepare cost estimates for procedures for cash patients.
</li><li>Adjust duties in cases of sudden or emergency unplanned leaves by colleagues.
</li><li>Manage and hand over any pending cases to the next shift colleagues.
</li><li>Perform any other tasks assigned by the HOD within the scope of the job title.
</li><li>Comply with all OSH and infection control policies, standards, and procedures, and cooperate with hospital management to meet these requirements.
</li><li>Work in accordance with documented OSH procedures, instructions, and specific responsibilities.
</li><li>Be familiar with emergency and evacuation procedures.
</li><li>Report OSH hazards, incidents, near misses, and issues, and assist with risk assessments and incident reports.
</li><li>Comply with waste management procedures and policies.
</li><li>Attend applicable OSH/Infection Control training programs, mock drills, and awareness programs.
</li><li>Use appropriate personal protective equipment and safety systems.</li></ul></div>
 <div><ul><li>Bachelor&rsquo;s Degree in Medicine (MBBS) from a recognized university.
</li><li>Minimum 2 years of experience in insurance claims management/adjudication.
</li><li>Experience in medical coding including ICD, CPT, DRG, and HCPCS.
</li><li>Excellent command of oral and written English.
</li><li>Flexible and able to work under pressure.
</li><li>Excellent knowledge of Microsoft applications.</li></ul></div>

Submission & Resubmission Officer

<div>2.1 Apply medical knowledge and best insurance practice while reviewing and verifying the Pre Approval requests (OP/ IP) received from different departments to obtain authorizations as required by insurance companies dependent upon the plan coverage for all Insurance patients. Ensure that the details of the Pre Authorization Requests are in line with the regulators&rsquo; standards especially the claim adjudication Rules and Business Rules.
 
2.2 Handling the rejected pre authorization and get required justification from the treating doctor to resend it to Insurance Company and obtain the approval.
 
2.3 Prepares reports of daily activity as requested for management and assists management in month end reporting as requested.</div>
 <div><ul><li>Evaluate Pre-Approval requests for medical necessity and accurately code service descriptions per medical coding rules, guidelines, and policy schedule of benefits.
</li><li>Respond to Insurance/TPA queries and liaise with relevant departments promptly.
</li><li>Receive, evaluate, and escalate second opinion cases and case management.
</li><li>Perform night shift duties and work on public holidays as per duty roster.
</li><li>Prepare daily activity reports for management and assist in monthly reporting.
</li><li>Handle auditing processes: arrange required documents, coordinate with coders, and assist external auditors.
</li><li>Attend meetings and presentations.
</li><li>Train front office, reception, and nursing staff on insurance updates.
</li><li>Prepare cost estimates for procedures for cash patients.
</li><li>Adjust duties in case of sudden or emergency unplanned leaves by colleagues.
</li><li>Manage and hand over pending cases to the next shift colleagues.
</li><li>Perform any other duties assigned by the HOD within the scope of the job.
</li><li>Comply with all OSH and infection control policies, standards, and procedures.
</li><li>Follow documented OSH procedures and specific responsibilities.
</li><li>Be familiar with emergency and evacuation procedures.
</li><li>Report OSH hazards, incidents, near misses, and assist in preparing risk assessments and incident reports.
</li><li>Comply with waste management procedures and policies.
</li><li>Attend OSH/infection control training, mock drills, and awareness programs.
</li><li>Use appropriate personal protective equipment (PPE) and safety systems.</li></ul></div>
 <div><ul><li>Bachelor&rsquo;s Degree in Medicine (MBBS) from a recognized university.
</li><li>Minimum 2 years of experience in Insurance Claims management/adjudication.
</li><li>Experience in Medical Coding: ICD, CPT, DRG, and HCPCS.
</li><li>Excellent command of written and spoken English.
</li><li>Flexible and able to work under pressure.
</li><li>Strong knowledge of Microsoft applications.</li></ul></div>

Approval Officer

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