Medical Coding Specialist

Job Purpose

Key Activities

• Follow all relevant policies, processes, standard operating procedures, and instructions and ensure work is carried out in a controlled and consistent manner.
• Promote the implementation and adherence to relevant policies, processes, and operating procedures to others.
• Contribute to the identification of opportunities for continuous improvement of systems, processes, and practices, taking into account leading practices, improvement of department processes, cost reduction, and productivity improvement.
• safety, quality, and environmental management policies, procedures, and controls to ensure safety, legislative compliance, delivery of high-quality service, and a responsible environmental attitude.
• Build high levels of trust and understanding with key internal and external stakeholders to promote full compliance with industry regulations and promote a broader understanding of Dallah Health’s interests and practices.

Functional Accountabilities

• Review patient medical records, including discharge summaries, operative reports, and clinical documentation.
• Assign accurate diagnosis and procedure codes using MOH-approved coding systems (e.g., ICD-10-AM, ICD-11).
• Ensure proper sequencing of codes in line with official coding guidelines and reimbursement rules.
• Perform routine checks to verify that assigned codes are accurate, consistent, and complete.
• Flag incomplete or unclear documentation and seek clarification through established query processes.
• Participate in internal coding audits and implement feedback from audit findings.
• Work with physicians, nurses, and Clinical Documentation Improvement (CDI) staff to resolve ambiguities that impact coding.
• Ensure all required data elements are present for correct coding and billing.
• Submit coded data within established timelines to support prompt billing and claims processing.
• Assist in addressing coding-related claim denials or rejections under the guidance of the Senior Coding Specialist or Coding Manager.
• Maintain strict confidentiality when handling patient information in line with MOH data privacy regulations and hospital policies.
• Report any suspected compliance or privacy issues to the Coding Manager.
• Keep up to date with changes in coding rules, guidelines, and reimbursement policies.
• Attend coding workshops, in-service training, or certification updates as required.

Job Qualifications and Requirements

• 2–4 years of relevant coding experience in a hospital environment
• Strong knowledge of MOH coding standards, Saudi data privacy requirements, and CBAHI/JCI accreditation frameworks.
• In-depth experience with ICD-10-AM, ICD-11, DRG grouping, and clinical documentation improvement practices.
• Familiarity with EMR systems and coding software.
• Bachelor’s degree in Healthcare Administration, Quality Management or a related healthcare field.
• Professional certification in coding (e.g., CCS, CPC) is preferred.
• Valid registration with the Saudi Commission for Health Specialties (SCFHS).
• Deep technical expertise in coding standards, documentation requirements, and coding compliance.

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