Senior Medical Coder

Company Description

Pyramids Health Services has been offering experienced home care services by specialized medical professionals in the UAE since 2012. PHS has been awarded with the highest level of accreditation in Long Term and Home Care by CARF (Commission on the Accreditation of Rehabilitation Facilities) International on 2017. Our wide range of services extend beyond basic home nursing to specialized physiotherapy and medical care in all situations providing short-term or long-term care in the home, depending on a person’s needs. We are qualified to source and operate medical equipment approved from referring hospitals and customized for the home setting and deliver safe ad smooth transitions.

Job Description

​​​​​​Senior Medical Coder who can reviews, analyzes, and accurately assigns standardized medical codes (e.g., ICD-9/10–CM, CPT, HCPCS, DRG) for home-based medical services. This ensures proper reimbursement, regulatory compliance, and coding integrity across the patient care documentation and billing cycle.

Key Responsibilities:

• Assigning ICD and CPT codes to Homecare and Outpatient center.
• Coordinate with insurance company for approvals.
• Responsible for handling the insurance clarifications and reporting the details to the insurance on timely basis.
• Handling Rejections and Resubmitting the E claims
• Communicating documentation improvement opportunities and coding issues to
• appropriate personnel
• Submission to all claims at the end of the day for outpatient
• Billing and submission of Homecare claims on every week without missing
• Communicating with co‐workers, for Preapproval documents and tracking the approval homecare approval expires cases.
• Query physician for clarification when documentation is inadequate, ambiguous, or unclear for coding purposes.
• TASNEEF and Abu dhabi insurance coding guidelines prepared and maintained all documents accordingly.
• Preparing Jawadha audit documents and tracking accordingly
• Providing support to management if any other RCM related
• Denial Management –Resubmitted the claims either rejected from insurance appropriate correction with detailed explanation as per the general coding guidelines and insurance specific rules.

Qualifications

• Bachelor's degree in related field preferred
• Bachelor's degree in medical related (Nursing, Physician, Physiotherapy )

Additional Information

• Mandatory Certification from CPC or CCS by AHIMA
• 2+ years’ experience as a medical coder
• Advanced understanding of medical terminology and administration processes
• MS Excel – proficient in Excel functions such as VLOOKUP and SUMIF; additional advantage