Specialist - Submission

SEHA (Abu Dhabi Health Services)
Abu Dhabi
Workplace: OnsiteFull timeFunction: Finance & AccountingExperience: 3+ yearsEducation: bachelorsSkills: ["Attention to detail","Problem-solving","Communication","Compliance","Analytical thinking"]

Review and analyze patient medical records to abstract clinical information and assign diagnostic and operative procedure codes for submission and pre-authorization. Ensure appropriate E&M coding based on clinician documentation, query physicians when needed, and contact clinics for supporting documents. Audit claims for accuracy and payer compliance, prevent billing discrepancies and revenue leakage, support resubmissions/denials, and stay current with clinical coding standards and regulatory requirements.

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SEHA (Abu Dhabi Health Services)
SEHA (Abu Dhabi Health Services)
2 days ago

Specialist - Submission

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Source: Company careers pageValidated by: Fursa AI
Last checked: 2 hours agoStatus: Live

Job Summary

Review and analyze patient medical records to abstract clinical information and assign diagnostic and operative procedure codes for submission and pre-authorization. Ensure appropriate E&M coding based on clinician documentation, query physicians when needed, and contact clinics for supporting documents. Audit claims for accuracy and payer compliance, prevent billing discrepancies and revenue leakage, support resubmissions/denials, and stay current with clinical coding standards and regulatory requirements.
Location: Abu Dhabi
Workplace: Onsite
Employment Type: Full time
Job Function: Finance & Accounting
Seniority: Mid level

Key Responsibilities

  • •Review and analyze patient medical records to ensure applicable patient data is available for coding.
  • •Abstract pertinent information from records and assign relevant codes, including pre-authorization coding.
  • •Review and assign appropriate E&M codes based on clinician documentation to support correct reimbursement.
  • •Audit medical claims for accuracy and compliance with payer guidelines, coding/billing standards, and organizational policies; identify discrepancies and prevent revenue leakage.
  • •Collaborate with coders, billers, physicians, and operational teams; support quality assurance/audits and handle resubmissions/denials.

Key Requirements

  • •Bachelor degree in Health Information Management or relevant field, or a diploma with 3 years of additional experience in healthcare.
  • •Review, abstract, and analyze clinical information from medical records and translate it into diagnostic and operative procedure codes using the clinical coding system.
  • •Assign appropriate codes for pre-authorization and review/assign E&M codes based on clinician documentation to ensure proper facility reimbursement.
  • •Query physicians and obtain additional documentation when records are unclear, ambiguous, or coding is not straightforward.
  • •Maintain compliance with clinical coding principles, payer/organizational guidelines, and regulatory/licensure and mandatory training timelines.
Experience:3+ yearsHealthcare
Education:Bachelor's in Health Information Management
Skills:Attention to detailProblem-solvingCommunicationComplianceAnalytical thinking

Company Brief

SEHA (Abu Dhabi Health Services)
SEHA (Abu Dhabi Health Services Company) is the UAE’s largest public healthcare network, operating hospitals, clinics and specialist centres across Abu Dhabi to deliver integrated, patient‑centred medical services and advanced clinical care.
Industry: Hospitals & Clinics
Company Size: Enterprise (1,001+ employees)
Growth: Public Company
Headquarters: Abu Dhabi, United Arab Emirates
Founded: 2007
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