Medical Coder-Resubmissions
Role Overview
The medical coder reviews, corrects, and resubmits denied, rejected, or unpaid insurance claims to support timely and accurate reimbursement.
The role analyzes denials, verifies coding accuracy, identifies documentation gaps, and applies payer requirements and regulatory guidelines.
Key Skills for This Role
Full Job Posting
About the organization
M42 provides healthcare services across primary and specialty care, with more than 480 facilities in 27 countries and over 20,000 professionals.
Danat Al Emarat is a women’s and children’s specialty hospital in Abu Dhabi, with services including neonatology, pediatrics, obstetrics and gynecology, women’s health, fetal medicine, and a Level III NICU.
Role overview
The medical coder reviews, corrects, and resubmits denied, rejected, or unpaid insurance claims to support timely and accurate reimbursement.
The role analyzes denials, verifies coding accuracy, identifies documentation gaps, and applies payer requirements and regulatory guidelines.
Responsibilities
- Review denied, rejected, and unpaid claims to identify root causes and corrective actions.
- Analyze medical records, coding, billing information, and supporting documentation for accuracy and payer compliance.
- Correct coding, demographic, authorization, eligibility, and billing errors before resubmission.
- Resubmit claims accurately within payer-defined timelines to maximize reimbursement and reduce revenue loss.
- Assign diagnosis and procedure codes in accordance with ICD-10-CM, CPT, HCPCS, and applicable coding guidelines.
- Investigate payer denials and underpayments, identify trends, and recommend process improvements.
- Collaborate with physicians, coders, billing teams, and revenue cycle staff to obtain clarification and supporting documentation.
- Prepare and submit appeals for denied claims with clinical and financial documentation.
- Monitor resubmitted claims and follow up with insurance companies to ensure timely resolution.
- Maintain records of denial reasons, resubmissions, appeals, and claim outcomes.
- Support internal and external audits with documentation and explanations of claim corrections and resubmissions.
- Ensure compliance with healthcare regulations, payer policies, and organizational procedures throughout resubmission.
Qualifications
- Bachelor's degree in Health Information Management, Medical Records, Healthcare Administration, Nursing, Pharmacy, or a related healthcare field.
- Professional coding certification such as CPC.
- Strong knowledge of ICD-10-CM, CPT, and HCPCS coding systems.
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