Senior Executive.Insurance.Medcare Hospital Sharjah (Br)

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.

• 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.

Education & Experience:

• 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.