Job Description
Transguard Workforce Solutions is the UAE’s leading provider of unique and innovative HR solutions. With a decade of experience in the region and a team that possesses extensive knowledge of the market, we provide a fully integrated HR solution.
We are currently recruiting for a Senior Officer - Medical Coding for our client to be based out of their Dubai office.
The overall role of the position is for Medical Claims Department in guiding medical coding practise, managing relationship with providers, negotiation with provider and maintaining quality assurance in claim practise.
- Interprets medical information such as diseases or symptoms, and diagnostic descriptions and procedures for a given visit to assign and sequence the correct ICD and CPT codes accurately.
- Provides technical guidance to other departmental staff in identifying and resolving issues or errors, ambiguous or nonspecific documentation, or codes that do not conform to approve coding principles/guidelines.
- Educates and advises Claims Units on proper coding standards and billing rules, documentation, procedures, and requirements. Perform regular Coding Quality Check on approvals generated by the Authorization Unit.
- Ensure to justify with documents to support, and stand on Coding related disputes with Providers.
- Support Network Management through validation of services and prices.
- Evaluates the process of provider empanelment
- Service addition received from the provider.
- Develops and updates procedures manuals to maintain standards for correct coding, minimize the risk of upcoding, and optimize revenue recovery.
- Handling the providing enquiry on medical coding and billing practices
- Price revision: Check for the previous utilization, do data simulation, impact analysis and propose feedback to line manager on the price revision.
- Attended to E-mails and calls. Respond to provider queries.
- Uploading pricelist in MIMS.
- Support other departments like Network & IT wherein coding knowledge is required for pricing or generation of New Applications.
- Reviews updates from regulatory website, and attends workshops to stay abreast of current issues, trends, and changes in the laws and regulations governing medical record coding and documentation laid by the regulators
- Identifies training needs, prepares training materials, and conducts training for staff and support staff to improve skills in the better understanding of coding to enhance quality health data.
- Preparing the monthly dashboard.
- Filtering and Analysing Providers’ data in the system, with the reflection of price changes.
- Attend all Clinical Coding Steering Committee Meetings.
- Attend all Workshops and conferences related to coding.
