Medical Coder

Medical Coder
Dubai or UK based with Hybrid working (up to ‎3 days WFH)
Permanent
Full time, ‎40 hours per week
Here you 'll be welcomed. We champion diversity and we understand the
importance of our people representing the communities and customers we serve.
You'll find an inclusive environment where you can be yourself and where
everyone is driven by the same purpose - helping people live longer,
healthier, happier lives and making a better world.
Bupa Global is the international health insurance division of Bupa. We provide
customers who want premium international coverage with products and services
to access the healthcare they need anytime, around the world, whether at home
or when studying, living, travelling or working abroad.
Bupa Global has offices around the world including London and Brighton (UK),
Dublin (Europe), Miami (USA), Dubai (UAE, in partnership with OIC), Egypt and
Hong Kong (China) as well as regional offices in mainland China, Singapore,
the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador.
Role Overview
To be considered for this role it is essential that you have CPT or ICD ‎10
medical coding experience.
* The Medical Coder will report directly into the Head of Data Analytics and Projects.
* They are responsible for monitoring and improving Bupa Global's Medical coding information which is to be stored in the PCMS system.
* They will ensure best practises for all CPT and ICD ‎10 coded claims and be able to design and lead on all analysis in the new coding structure. This will support claims payment integrity, provider and partner management and care management activities in the wider HCM team.
* They will liaise with the various internal stakeholders in a range of departments to communicate findings and financial impact.
What you 'll do:
* To lead on all medical coding developments for the Healthcare Management Team.
* To ensure the accuracy and completeness of the clinical coded records which exists within the PCMS system.
* To provider expert guidance on medical coding requirements of all HCM linked project work.
* To be the go-to expert for all CPT and ICD coding queries.
* To conduct analysis of newly coded claims experience, offering insight and opportunities of closer claims management and better customer experience.
* Assess providers coding and billing behaviour and develop guidelines to enforce best practices in line with each market standards, common practices and rules and regulations. Ensure that these best practices are followed internally and by service partners.
* Propose new ways to improve the foundation of the healthcare providers pricing benchmark by leveraging CPTs information.
* Advanced understanding of the various international healthcare system billing standards including DRGs and be the subject matter expert to lead on the technical changes required affecting the processes, technology and people knowledge.
* Conduct pricing and financial impact analysis on claims arising from changes related to billing, coding, pricing, and unforeseen crisis.
* Support in the measurement of HCM business health indicators agreed with Service Partners, Key Providers, at Benefits & Policy levels as per the standard metrics & ad-hoc needs.
* Support the head of networks contracts service charges negotiation with providers and / or target partners to enable access to healthcare, delivering financial and commercial advantage through best price and quality care for our customers. Serve as resource and subject matter expert to other coding staff.
* Achieve personal targets and develop pipeline for future activity.
* Interface with other teams in HCM to ensure that terms and conditions agreed with our service partners and provider network can be implemented and delivered effectively. Obtain feedback and recommendations from our network partners and disseminate this information within Global to improve the level of service to our customers.
* Understand, comply with and abide by the regulatory requirements of relevant markets within the region including, but not limited to, the Financial Services Authority (FSA) and Financial Ombudsman Service (FOS).
What you 'll bring:
* Strong medical and clinical coding experience - CPT / ICD ‎10 essential
* Perfect command of English, both written and verbal.
* Strong commercial knowledge of the health insurance industry; knowledge of healthcare systems, ideally within a global setting.
* Strong insight knowledge of regional hospital industry and its pricing and quality dynamics.
* Ability to perform medical coding independently, but also experience of managing and overseeing teams of medical coders.
* Ability to deliver projects on time, budget and within agreed quality.
Why Bupa?
We are a health insurer and provider. With no shareholders, our customers are
our focus. We reinvest profits into providing more and better healthcare for
the benefit of current and future customers.
Diversity and Inclusion
Bupa is committed to making sure that every applicant is assessed solely on
personal merit and qualifications. We actively celebrate the diversity of our
colleagues and provide an inclusive environment so you can bring your true
self to Bupa. We'll make sure you are treated fairly. That's why we're happy
to offer reasonable adjustments as part of our recruitment process to anyone
that needs them.
Whether you've found your feet or are discovering a new path.
Welcome to a place that celebrates you.
This isn't where you've been.
This is where you're going.
This is what we have belief in.
Time Type:
Full time