Senior Executive.Insurance.Medcare Hospital Sharjah (Br)

Senior Executive.Insurance.Medcare Hospital Sharjah (Br)

Job Description

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.