Outpatient Coding Officer (Al Dhafra Hospital)

SEHA Hospital Coder will competently navigate the patient health record and other computer systems/sources in the determination of appropriate diagnoses and procedures.

Codes Routine Outpatient health records (utilizing encoder software and online tools and references in the assignment of codes).

Consults reference materials to facilitate code assignment.

Validates charges by comparing charges with health record documentation as necessary.

Understands the appropriate link of diagnosis to procedure when applicable.

Appends modifier(s) to procedure or service code when applicable.

Utilizes retrospective edit tool to address possible coding and/or documentation issues related to submitted diagnosis and procedure information obtained from the health record.

Consults with CDI, physicians, or other healthcare providers when additional information is needed for coding and/or to clarify conflicting or ambiguous information.

Collaborates with Revenue Cycle Management teams in resolving billing and utilization issues affecting reimbursement.

Interprets bundling and unbundling guidelines (NCCI).

Tracks issues (i.e., missing documentation or charges) that require follow-up to facilitate coding in a timely fashion.

Investigates claims denials and/or appeals as directed.

Consistently meets or exceeds coding quality and productivity standards established by Revenue Excellence.

Maintains up-to-date knowledge of changes in coding and reimbursement guidelines and regulations.

Identifies concerns and is responsible for providing resolution of moderate to complex problems.

Notifies appropriate leadership for resolution when appropriate.

Performs other duties as assigned by Leadership.

Maintains a working knowledge of applicable coding and reimbursement with UAE laws and regulations, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

Coding Assign ICD-10-CM and CPT codes to outpatient (OP)/emergency department (ED) medical records and captures charges for emergency department records;

Adheres to official coding guidelines when coding with accuracy and completeness as supported by documentation;

Interact with physicians and other areas when additional coding information is needed;

Appropriately utilizes encoder and coding references;

Assigns appropriate code(s) by utilizing coding guidelines established by UAE regulatory agencies;

Utilizes ICD-CM Official Coding Guidelines for Coding and Reporting;

Utilizes American Hospital Association (AHA) Coding Clinic for International Classification of Diseases, Clinical Modification;

American Medical Association (AMA) CPT Assistant for CPT codes;

American Health Information Management Association (AHIMA) Standards of Ethical Coding

Qualification :-

Abu Dhabi Healthcare Company (SEHA) is the largest and most comprehensive healthcare network in the UAE that was established in 2007 with the objective of operating all public hospitals and clinics across the Emirate of Abu Dhabi.

SEHA is committed to delivering world-class healthcare services using the most advanced diagnostics and systems across its network of public healthcare centers and hospitals in addition to partnering with global leaders in healthcare, including world renowned organizations such as the Mayo Clinic.

Al Dhafra hospitals is a premier medical institution located in Al Dhafra, encompassing six hospitals which are Madinat Zayed, Ghayathi, Marfa, Delma, and Liwa. In addition, the institution also includes four clinics which are Bida Mutawa, Abu Al-Abyad Clinic, Sir Bani Yas Clinic, and Al Dhafra Family Medicine Center (DFMC). Together, these hospitals and clinic provide coverage across 16 different specialties including inpatient and outpatient medical services covering different fields and specialties, including internal medicine, pediatrics, gynecology & obstetrics, general surgery, anesthesia, pharmacy services, laboratory and diagnostic radiology.