Job Description

Primary Responsibilities:

Review inpatient medical records to accurately assign diagnosis-related groups (DRGs) and procedure codes based on ICD-10-CM, ICD-10-PCS, and CPT coding guidelines. Analyze the healthcare revenue cycle from patient registration to final payment, identifying inefficiencies and opportunities for improvement. Monitor claims processing, payment posting, denials management, and accounts receivable. Investigate reasons for claim denials or delays and recommend corrective actions to reduce denials and accelerate cash flow. Collaborate with coding, billing, and clinical teams to ensure accurate and compliant charge capture. Generate and analyze reports on key performance indicators (KPIs) like days in accounts receivable, denial rates, and collection rates. Support implementation of new technologies or process improvements to optimize revenue cycle performance. Assist in training staff on best practices related to coding, billing, and revenue cycle processes. Ensure compliance with regulatory requirements impacting revenue cycle operations. Analyze clinical documentation to ensure completeness, accuracy, and compliance with coding standards and regulations. Ensure proper coding for inpatient stays to optimize reimbursement and reduce claim denials. Collaborate with physicians, clinical staff, and billing departments to clarify documentation discrepancies and improve coding accuracy. Stay updated with changes in coding regulations, payer guidelines, and compliance requirements. Conduct regular audits and quality checks to ensure coding accuracy and consistency. Assist in data reporting and provide insights on coding trends or patterns impacting revenue. Maintain knowledge of hospital billing and reimbursement processes related to DRG payments.

Job Requirements:

Bachelor in Life Sciences Most relevant coding certification with updated membership to a body as accepted by the geographical governance area (AAPC or AHIMA). Relevant experience of at least 1 year in medical coding. Should at least have basic knowledge of Evaluation and Management services. Prior hands on experience would be an added advantage. Experience in UAE coding will be an added advantage.
Job Type: Full-time