Senior Medical Coder

Job Overview:

The Senior Insurance Medical Coder will be based at IBO Medical center Sharjah and will be responsible to support our outpatient services by accurately coding medical records and procedures in compliance with UAE insurance and regulatory guidelines. The ideal candidate will ensure proper claim submission, reduce rejections, and maximize revenue cycle efficiency in coordination with physicians, billing, and insurance teams.

Key Responsibilities:

• Ensure 100% claim submission of IBO Medical center within the agreed time frame.
• Review outpatient clinical documentation and assign accurate CPT, ICD-10, and HCPCS codes.
• Ensure coding accuracy and compliance with DHA/MOH/DOH regulations and payer-specific requirements.
• Validate insurance approvals, coverage policies, and coding requirements before claim submission.
• Cross-check diagnosis and procedure codes with physician documentation for consistency.
• Collaborate with doctors and clinical staff to clarify diagnoses or obtain missing information.
• Support the billing team in resolving claim rejections or denials due to coding discrepancies.
• Keep updated with insurance guidelines, coding rule changes, and payer-specific circulars.
• Generate coding-related audit reports to ensure documentation and billing accuracy.
• Assist in internal and external audits, including compliance checks and pre-insurance assessments.
• Focus on zero rated rejection for all the submitted claims.
• Closely work with claim processing team to ensure timely claim submission (2nd of every Month) and resubmission (21 days) process is carried out effectively
• Complete special tasks assigned by the Reporting Manager.
• Complete the recon resubmission and closure with all insurance companies within the time line.
• Maintain relationship with customers by professional conduct and response to queries over standard guidelines in effective communication.
• Participate in ongoing training sessions and contribute to improving coding workflows.

Qualification & Experience:

• Bachelor’s Degree in a medical or healthcare-related field.
• Certified Professional Coder (CPC) or equivalent certification (AAPC/AHIMA recognized).
• Minimum 5–7 years of UAE experience in medical coding, specifically outpatient coding in Medical centers or Day care Surgery Centers in Northern Emirates.
• Certified Professional Coder (CPC) or equivalent certification (AAPC/AHIMA recognized).
• Sound knowledge of CPT, ICD-10, and HCPCS coding systems.
• Familiarity with DHA/MOH/DOH insurance regulations and payer portals (e.g., eClaimLink, Riayati, Shafafiya).
• Proficient in Microsoft Office and EMR/HIS systems.
• Excellent attention to detail and organizational skills.
• Strong communication and teamwork abilities.