Sr. Medical Coder
Job details
We are looking for a Sr. Medical Coder who is highly proficient in computer software and Microsoft applications, holding a license/certification in AAPC/AHIMA with wide knowledge and understanding of HAAD / DHA / IA guidelines, rules & standards.
Educational Qualification:
Graduate in Nursing/ MBBS/BAMS + license/certification in AAPC/AHIMA
Additional Requirements:
Minimum 5 years experience in UAE, having experience in an insurance company / TPA is an added advantage
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.
Coordinate with Claims, Network and Finance team for recovery payment related communications and collection of same.
Involve in recon closure procedures with reconciliation team.
Active participation in provider meetings related with audit and recon closure.
Provide coding related support to the approval team for IP DRG claims cost finalization & OP procedure coding.
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