IP Coding Officer-DRG Experience

Job Description

JOB PURPOSE:

• Establish and maintain the diagnostic/procedural coding system as approved by the hospital's medical/administrative directive and Dubai Health Authority
• Code all relevant, current and documented diagnoses and procedures as performed by attending physicians utilizing the appropriate ICD coding
• Abstract all demographic, statistical and medical information from each patient record and enter the data into the coding/abstracting system
• Review Claims for all prescribed diagnostics and pharmacy items along with procedures and complications as documented in the EMR, Claim Form/ operative reports. Assign appropriate codes and send a request to physician wherever required.
• Apply the appropriate guidelines for assignment of principal and secondary procedures utilizing the CPT 4 procedure code when reviewing claims with Inpatient Coordinator for billing purposes/DRG billing. Assign Initial DRG and Final DRG
• Responsible for thoroughly knowing and utilizing all coding systems both inpatient and outpatient according to the most recent rules, regulations, and conventions.
• Review rejections and resubmit such claims from payers and assign appropriate codes based on response from physicians for queries raised after rejection
• Review scrubber software report details & amend the coding in HIS based-on query response and documentation in EMR
• Provide technical guidance to physician's and other departmental staff in identifying and resolving issues or errors such as Incomplete or Missing records and documentation, ambiguous or nonspecific documentation, or codes that do not confirm to approved coding principles/guidelines
• Prepare and update exclusions by Payers based on ICD10 codes and CPT
• Prepare benefit plans based on insurance contracts
• Prepare monthly claims for E submission and monthly reports of productivity and completion of coded batches
• Experience: A minimum of 3+ years experience of working in Coding Company with DRG Coding experience i a busy hospital setup in Dubai or Abu Dhabi DRG coding.

Education:

BDS/Bachelor of Pharmacy/Medical-related qualification

Sound knowledge of DHA DRG guidelines and insurance protocols

Certification: CPC or CCS is desired

Candidates meeting the above criteria only will be contacted.