1mo ago

Senior Executive.Insurance.Medcare Hospital Sharjah (Br)

United Arab Emirates·Sharjahsenior

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Overview

Your Responsibilities- Review and assign accurate ICD-10 and CPT codes for healthcare services. Perform IR DRG/MS DRG coding in accordance with coding guidelines and industry standards.

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Responsibilities

~1 min read

→Review and assign accurate ICD-10 and CPT codes for healthcare services.
→Perform IR DRG/MS DRG coding in accordance with coding guidelines and industry standards.
→Analyze DRG severity and Case Mix Index (CMI) to ensure accurate reimbursement and compliance.
→Utilize the Query Management System (QMS) to identify documentation improvement opportunities and support Clinical Documentation Improvement (CDI).
→Ensure compliance with UAE healthcare regulations, insurance policies, and payer billing guidelines.
→Collaborate with physicians and other healthcare professionals to ensure accurate coding and billing practices.
→Maintain complete knowledge of provider and payer billing guidelines.
→Support coding quality initiatives and ensure coding accuracy.

Minimum 2 years of experience in the Medcare RCM team or a similar medical coding role.
Strong knowledge of IR DRG/MS DRG coding concepts and coding guidelines.
Excellent case mix analysis and decision-making skills.
Experience in MS DRG or Surgery coding for US projects is an added advantage.
Good understanding of UAE healthcare regulations and insurance processes.
Certification from AAPC or AHIMA is mandatory.
Bachelor's degree in Life Sciences or a Doctorate degree.