Senior Medical Coder

Job Description

The Senior Medical Coder is responsible for ensuring the accurate, compliant, and timely coding of clinical documentation in accordance with Saudi Arabian healthcare regulations, ICD-10-AM standards, Saudi Billing Syste (SBS) and payer-specific guidelines. This role supports optimal reimbursement and maintains high standards of data quality for healthcare institutions. The senior coder reviews clinical documentation collaborates closely with medical staff and actively participates in auditing and validation processes. Proficiency in ICD, Saudi Billing Syste (SBS) (ACHI/ACS) coding systems, along with a strong understanding of Saudi Arabian healthcare policies is essential. The position also requires effective use of electronic health records (EHR) and coding software, contributing to the overall accuracy and integrity of the hospital’s clinical and financial data.

Job Responsibilities

• Assign appropriate diagnosis and procedure codes using ICD-10-AM, SBS, and other relevant coding systems.
• Review medical records to ensure that clinical information justifies the procedures or treatments being coded.
• Ensure coding accuracy and compliance with MOH, NHIC, and payer specific regulations in Saudi Arabia.
• Ensure that all documentation is complete and accurate to support the assigned codes.
• Work with IT teams to integrate AI tools into current coding workflows, ensuring smooth operation and minimal disruption
• Review and validate AI-suggested ICD codes to ensure they comply with current coding guidelines and regulations.
• Identify and troubleshoot issues with AI coding tools, working with technical teams to resolve problems.
• Conduct periodic testing of AI-generated ICD & SBS coding to maintain high standards of accuracy
• Perform quality audits and provide feedback to clinical and coding teams.
• Identify gaps, inconsistencies, or ambiguities within the clinical documentation.
• Stay updated on changes in coding regulations, compliance requirements, and industry updates.
• Have complete knowledge of billing guidelines of the provider and payer.
• Foster a collaborative and positive work environment within the team, promoting open communication and knowledge sharing.
• Oversee the review and quality control processes to ensure that all content meets accuracy, precision, and relevance standards
• Facilitate regular meetings and discussions to address documentation issues and promote best practices.

Qualifications & Skills

▪ Bachelor’s degree in medicine / nursing is mandatory.
▪ Certified Clinical Coder (CCC- ICD-10-AM/SBS/ACS)/ CCS certification is required.
▪ Strong experience with Saudi Billing System (SBS). ▪ Minimum 5+ years of experience in medical coding for Saudi Market, with at least 2 years at a senior or auditing level.
▪ Strong understanding of Saudi healthcare coding standards, including ICD-10-AM.
▪ Experience with DRG-based coding and auditing in Saudi Arabia.
▪ Exceptional knowledge of medical terminology, anatomy and physiology, treatment modalities, diagnostic tests, and medications.
▪ Proficiency with EHR systems and experience using coding and auditing software.
▪ Skilled in resolving discrepancies and addressing coding issues.
▪ High level of accuracy and attention to detail to ensure correct coding
▪ Effective communication with healthcare providers, billing departments, and other stakeholders.
▪ Demonstrated ability to prepare comprehensive healthcare content policies and guidelines.
▪ Excellent interpersonal and communication skills, promoting effective collaboration within the team and across departments.