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Medical Coder

  • Job
    Full-time
    Junior & Mid Level
  • Accounting & Tax
    Healthcare
  • Dubai

AI generated summary

  • You must follow SOPs and coding guidelines, verify patient details and documentation, confirm correct CPT/ICD codes, ensure invoiced investigations match services, and possess a Bachelor's with CPC Coding/AAPC.
  • You will verify patient details, ensure accurate CPT and ICD coding, match services with documentation, check claims for compliance, and submit to insurance, ensuring correct payer interactions.

Requirements

  • Follow the mandatory SOP, checklist and relevant payer and coding guidelines.
  • Checking demographic details of patient and make sure the front desk should select the proper regulatory policy (DHPO or RIAYATI)
  • Proper documentations are entered in the Chart/ EMR/ Claim form by the doctors.
  • Supporting details/ justification available in EMR of all investigation done.
  • Checking all CPT codes entered are correct based on CPT guidelines.
  • Checking excluded ICD and CPT based on Coding guidelines.
  • Approved services and rendered services are match.
  • Ensuring all requested investigations are done and invoiced.
  • Check the claim with correct Receiver and Payer name before finalizing the bill.
  • Check the claim with correct Patient Copay application.
  • Ensure all claims are submitted to insurance company.
  • Check the payer’s name, rate plan and plan name selected properly.
  • Bachelor with CPC Coding/AAPC

Responsibilities

  • Follow the mandatory SOP, checklist and relevant payer and coding guidelines.
  • Checking demographic details of patient and make sure the front desk should select the proper regulatory policy (DHPO or RIAYATI)
  • Proper documentations are entered in the Chart/ EMR/ Claim form by the doctors.
  • Supporting details/ justification available in EMR of all investigation done.
  • Checking all CPT codes entered are correct based on CPT guidelines.
  • Checking excluded ICD and CPT based on Coding guidelines.
  • Approved services and rendered services are match.
  • Ensuring all requested investigations are done and invoiced.
  • Check the claim with correct Receiver and Payer name before finalizing the bill.
  • Check the claim with correct Patient Copay application.
  • Ensure all claims are submitted to insurance company.
  • Check the payer’s name, rate plan and plan name selected properly.

FAQs

What is the primary responsibility of a Medical Coder in the Submission Team?

The primary responsibility is to follow the mandatory SOP, checklist, and relevant payer and coding guidelines to ensure accurate coding and billing processes.

Is there a specific educational requirement for this position?

Yes, a Bachelor's degree along with CPC Coding certification from AAPC is required.

How do Medical Coders ensure the accuracy of patient information?

Medical Coders check the demographic details of patients and ensure the front desk selects the proper regulatory policy (DHPO or RIAYATI).

What documentation practices are required from doctors?

Proper documentation must be entered in the Chart, EMR, and Claim form by the doctors, including supporting details and justification for all investigations done.

What guidelines do Medical Coders follow for CPT codes?

Medical Coders check that all CPT codes entered are correct based on CPT guidelines and also verify excluded ICD and CPT codes according to coding standards.

How is the accuracy of claims verified before submission?

Claims are checked for the correct Receiver and Payer name, correct Patient Copay application, and that all approved services match the rendered services before finalizing the bill.

Are all claims submitted to insurance companies?

Yes, ensuring all claims are submitted to the insurance company is part of the job responsibilities.

What should be done if requested investigations are not invoiced?

Medical Coders must ensure that all requested investigations are done and properly invoiced.

How do Medical Coders verify payer information?

They check the payer’s name, rate plan, and plan name to ensure proper selection during the claims process.

Delivering personalised care that matters.

Science & Healthcare
Industry
10,001+
Employees
1974
Founded Year

Mission & Purpose

NMC Healthcare is one of the largest private healthcare networks in the United Arab Emirates, and the third largest in Oman. Since 1975, we have provided high quality, personalised, and compassionate care to our patients and are proud to have earned the trust of millions of people in the UAE and around the world. ---------------------------------------- DISCLAIMER: Fraudulent Job Offers ---------------------------------------- It has come to our attention that fake job offers have been circulated under the name of NMC Healthcare by certain individuals/entities claiming that they are representatives or subsidiaries or under contract with NMC Healthcare. If you receive any unauthorised, suspicious, or fraudulent offers or interview calls, please send an email to verification@nmc.ae for formal verification. If you believe you have been a victim of a recruitment fraud, you are encouraged to approach the law enforcement agencies immediately.