Senior Clinical Coding Quality Specialist

Job Title: Senior Clinical Coding Quality Specialist

Location: United Arab Emirates (Remote)

Employment Type: Full-Time

Work Arrangement: 100% Remote — Work From Home

Level: Senior

About the Role

We are seeking an experienced Senior Clinical Coding Quality Specialist to oversee the accuracy, consistency, and compliance of clinical coding activities across healthcare records and medical claims. The role involves reviewing coded clinical documentation, identifying coding discrepancies, validating diagnosis and procedure classifications, and ensuring adherence to applicable coding standards and payer requirements. The successful candidate will collaborate with clinical documentation teams, medical coders, healthcare providers, billing specialists, and quality assurance professionals to strengthen coding accuracy, improve reimbursement integrity, and support effective clinical data reporting.

Key Responsibilities

• Conduct quality reviews of clinical coding records to verify accuracy, completeness, and consistency.
• Audit diagnosis and procedure codes against medical records, physician documentation, and applicable coding guidelines.
• Review coding assignments involving inpatient, outpatient, emergency, surgical, and specialty healthcare services.
• Validate the appropriate use of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, or other applicable classification systems.
• Assess the accuracy of principal diagnoses, secondary diagnoses, procedures, and supporting clinical indicators.
• Identify coding errors, omissions, inconsistencies, unsupported diagnoses, and inappropriate code assignments.
• Review medical documentation to determine whether assigned codes are adequately supported by clinical evidence.
• Evaluate compliance with official coding guidelines, payer policies, and applicable healthcare regulations.
• Conduct focused audits on high-risk specialties, complex procedures, and frequently disputed coding categories.
• Analyze coding error trends and identify recurring documentation or classification issues.
• Provide clear audit findings, corrective recommendations, and feedback to clinical coding teams.
• Coordinate coding clarification requests and documentation queries through approved clinical governance processes.
• Support clinical documentation improvement initiatives to strengthen the quality and specificity of medical records.
• Review coding-related claim denials, reimbursement discrepancies, and documentation-based rejections.
• Monitor coding quality indicators, productivity measures, accuracy rates, and audit performance.
• Develop and maintain coding audit tools, quality checklists, review templates, and standard operating procedures.
• Support internal and external audits by preparing coding evidence, review records, and compliance documentation.
• Monitor updates to coding standards, classification systems, payer requirements, and relevant regulatory guidance.
• Deliver technical training and guidance to medical coders on coding accuracy and documentation requirements.
• Collaborate with clinical, revenue cycle, compliance, and health information management teams.
• Prepare periodic quality reports highlighting coding performance, error categories, risk areas, and improvement actions.
• Recommend process improvements to enhance coding consistency, audit effectiveness, and operational efficiency.

Qualifications and Experience

• Bachelor's degree in Health Information Management, Health Informatics, Nursing, Medical Sciences, or a related healthcare discipline.
• Significant experience in clinical coding, coding quality assurance, medical records auditing, or healthcare revenue cycle management.
• Strong knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, or other relevant clinical coding systems.
• Experience reviewing inpatient, outpatient, surgical, and specialty clinical documentation.
• Understanding of principal diagnosis selection, sequencing rules, procedure coding, and coding conventions.
• Knowledge of clinical terminology, anatomy, physiology, and common medical procedures.
• Experience conducting coding audits and preparing detailed quality assessment reports.
• Familiarity with clinical documentation improvement principles and physician query processes.
• Understanding of medical necessity, coding compliance, reimbursement requirements, and claims adjudication.
• Knowledge of healthcare privacy, confidentiality, and medical record governance requirements.
• Ability to interpret complex medical records and identify inconsistencies between documentation and assigned codes.
• Strong analytical, research, and problem-solving skills.
• Excellent written communication and technical reporting abilities.
• Proficiency in electronic health records, coding platforms, audit systems, and Microsoft Office applications.
• Ability to manage multiple coding review assignments and quality deadlines independently.
• High standards of accuracy, objectivity, confidentiality, and professional integrity.
• Recognized coding credentials such as CCS, CPC, CIC, RHIA, RHIT, or equivalent qualifications are advantageous, subject to applicable local requirements.

What We Offer

• A fully remote working arrangement within the UAE employment context.
• Competitive compensation aligned with experience and professional qualifications.
• Opportunities to contribute to healthcare coding quality and compliance improvement.
• Professional development in clinical coding standards, audit methodologies, and health information management.
• A collaborative environment involving clinical, coding, compliance, and healthcare operations professionals.

How to Apply

Interested candidates should submit an updated CV highlighting their clinical coding experience, audit expertise, knowledge of coding classification systems, and relevant professional certifications.

Email Subject: Application – Senior Clinical Coding Quality Specialist (UAE Remote)

Candidates should confirm applicable employment arrangements, residency requirements, and work authorization before accepting an offer. This role focuses on remote coding audits, clinical documentation review, quality monitoring, reporting, and technical guidance. Clinical diagnoses, medical judgments, physician documentation amendments, and formal clinical decisions must remain the responsibility of appropriately licensed healthcare professionals. Any regulated coding certifications, official submissions, or activities requiring specific professional authorization must be completed or approved by appropriately qualified and authorized personnel in accordance with applicable requirements. All patient information must be handled securely and in compliance with applicable privacy and data protection standards.