OP Medical Coder

About the role

Sunny Hamad Pharmacy Group Head Office is hiring an OP Medical Coder in Sharjah. The coder reviews clinical documentation and assigns standardized medical codes to diagnoses, procedures and treatments for billing, insurance claims and accurate medical records.

Key responsibilities

• Follow mandatory SOPs, checklists and payer and coding guidelines.
• Check patient demographics and ensure the front desk selects the correct regulatory policy (DHPO or RIAYATI).
• Verify that doctors enter complete documentation in the chart, EMR and claim forms, with supporting details for every investigation.
• Check that all CPT codes are correct according to CPT guidelines, and that excluded ICD and CPT codes are applied correctly.
• Ensure approved and rendered services match, and that all requested investigations are done and invoiced.
• Check claims for the correct receiver and payer names, copay applications, payer rate plan and plan name before finalizing bills.
• Submit all claims to the insurance company.

Required profile

• Bachelor's degree or diploma in any medical discipline or related field.
• Coding certification, such as CPC (Certified Professional Coder, AAPC).

Required skills

• ICD-10-CM (diagnosis codes)
• CPT (procedure codes)
• HCPCS Level II (supplies, equipment, services)