Medical Coder - Medical Coding Documentation

Position Overview

We are seeking a highly skilled and detail-oriented Medical Coder to join our dynamic team, specializing in medical coding documentation within the Kingdom of Saudi Arabia. In this pivotal role, you will play a critical part in ensuring compliance with local and international coding standards while supporting billing integrity and revenue cycle optimization. Your expertise will be instrumental in translating complex clinical documentation into accurate codes, resolving coding discrepancies, and fostering seamless collaboration between payers, regulators, and healthcare providers. This position requires a deep understanding of Saudi clinical coding systems, including the Saudi Billing System (SBS), CCHI Coding Standards, and Australian Coding Standards (ACS), along with the ability to interpret and implement region-specific guidelines.

Key Responsibilities

The Medical Coder will be responsible for the following core duties:

• Clinical Documentation Analysis: Review and analyze medical records to abstract relevant data, ensuring accurate assignment of codes in accordance with the Saudi clinical coding system and established standards. This includes interpreting ICD-10-AM (10th edition), ACHI, and SBS codes, as well as drug standards codes from the HUMAN DRUGS LIST.
• Rule Development and Maintenance: Collaborate with payers, regulators, and healthcare providers to create, refine, and implement rules that support billing integrity and best practices. This involves investigating and resolving coding or billing issues, ensuring compliance with regulatory policies, and addressing denials or discrepancies in the Saudi market.
• Subject Matter Expertise: Serve as a go-to resource for clinical coding queries within the KSA Rules unit, providing guidance on Saudi Billing System protocols, CCHI Coding Standards, and Australian Coding Standards. Ensure the integrity of the rules engine by defining and implementing correct coding principles.
• Cross-functional Communication: Facilitate email correspondence and troubleshoot coding-related requests, suggestions, and queries across departments. Prepare crosswalks to analyze local market practices and remittance advices, ensuring alignment with regulatory and payer requirements.
• System Maintenance and Scrubbing: Perform timely updates and maintenance of the rules engine to reflect evolving coding guidelines and local market practices. This includes scrubbing the system to ensure accuracy and compliance with Saudi healthcare regulations.

Qualifications and Skills

To excel in this role, candidates must meet the following requirements:

• Experience: Minimum of 2-5 years of hands-on experience as a Medical Coder within the Kingdom of Saudi Arabia, with a strong background in medical billing within the private healthcare insurance sector.
• Certification: Recognized professional certification in medical coding is highly desirable. Candidates with prior experience working with insurance payers will be given preference.
• Regulatory Knowledge: In-depth understanding of KSA local market regulations, including CCHI, Health Council, and SEBAHI standards, is essential to ensure compliance and accuracy in coding practices.
• Technical Proficiency: Strong proficiency in Healthcare Information Systems and Microsoft Office Suite (Word, Excel, PowerPoint, etc.) to support data analysis, documentation, and reporting.
• Communication and Leadership: Excellent verbal and written communication skills, with the ability to collaborate effectively across teams and provide clear guidance on coding standards and practices.
• Language Skills: Fluency in both Arabic and English is preferred to facilitate seamless communication with stakeholders in the Saudi healthcare ecosystem.
• Medical Background: Prior medical training as a Doctor, Nurse, or Pharmacist is highly desirable, providing a strong foundation for understanding clinical documentation and coding requirements.

Why Join Us?

As a Medical Coder in our organization, you will have the opportunity to contribute to the advancement of healthcare billing integrity in Saudi Arabia while working alongside industry experts. This role offers a dynamic and collaborative work environment, where your expertise will directly impact the efficiency and accuracy of revenue cycle operations. If you are a detail-oriented professional with a passion for medical coding and a commitment to excellence, we invite you to apply and become a key player in shaping the future of healthcare compliance in the region.