Assistant Clinical Coder American Hospital Dubai

An Assistant Clinical Coder performs various tasks including assigning procedural codes, HCPCS codes, and diagnosis codes during pre-authorization. The incumbent ensures accurate code assignment following established guidelines and Dubai Health Authority e-claims guidelines, addresses rejections and reports trends for process improvement. He/ she encodes diagnoses and procedures, abstracts patient information, understands insurance policies, and reviews electronic statements.

Responsibilities of Assistant Clinical Coder

• Collaborates with physicians to ensure accurate documentation, applies coding guidelines, reviews approval tracks, and addresses coding edits for medical necessity.
• Monitors productivity and ensures timely closure and dispatch of insurance, corporate, and self-pay batches according to schedule.
• Supports activities of the Revenue Cycle Management Department such as assigning procedural codes, HCPCS codes and diagnosis codes at the pre-authorization level.
• Ensures accurate assignment and verification of diagnosis and procedure codes following established coding guidelines and Dubai Health Authority (DHA) e-claims guidelines for all Hospital Claims including self-pay.
• Establishes and maintains the diagnostic/procedural coding system as approved by the hospital’s medical/administrative directives.
• Reviews rejections from payers and assigns appropriate codes based on responses from physicians for queries raised after rejection.
• Reports Utilization Trends, Documentation Issues, and Billing Issues for Process/Performance Improvement.
• Encodes all relevant, current and documented diagnoses and procedures as performed by attending physicians utilizing the appropriate International Classification of Diseases (ICD) coding.
• Creates an abstract of all demographics, statistical and medical information from each patient record and enters the data into the coding/abstracting system.
• Understands Health Insurance Policy Terms, Coverage, Exclusions & Approval requirements as per the contractual and regulatory obligations.
• Reviews electronic statements for all prescribed diagnostics and pharmacy items along with procedures and complications as documented in the Electronic Medical Record (EMR), and claim form/operative reports.
• Assign appropriate codes and send a request to the physician wherever required.

Other Duties

• Applies the appropriate guidelines for the assignment of principal and secondary procedures utilizing the CPT-4 procedure code when reviewing claims with the Outpatient Coordinator for billing purposes.
• Reviews approval tracks are entered for all approval-required services like Antenatal Consultations, Diagnostics such as CT, MRI, and Surgical Procedures etc. as per the Quick Chart/DPP.
• Ensures Billed Services should be as per the approval provided by the Insurer/Corporate.
• Reviews repetition of services within the same day and clarifications/medical necessity is sought from Physicians/Laboratory/Medical Imaging, etc.
• Reviews Coding Edit Engine of Dubai (CEED) filtered Medical necessity/coding edits. Ensures additional ICD codes are applied as required/suggested by the Insurance Coordinator.
• Send and report physician queries.
• Achieve daily productivity.

Qualifications & Experience

Following are the requirements for the role of Assistant Clinical Coder at American Hospital Dubai:

• Bachelor’s Degree in any field, Medical preferable.
• Certified Coding Specialist (CCS) accredited by the American Health Information Association (AHIMA) or
• Certified Professional Coder (CPC) accredited by the American Academy of Professional Coders (AAPC).
• Minimum zero (0) to one (1) year of experience in ICD-9-CM or ICD-10 coding in an organization handling claims.

Knowledge & Skills

• Knowledge of Health Insurance Policy Terms, Coverage and Exclusions in the UAE preferable.
• Skills in Microsoft Office (e.g. Excel, Word, PowerPoint, Outlook, etc.).
• Ability to speak and write in English.
• Ability to communicate in Arabic desirable.

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