Medical Claims Processor- Medical Coding

Job description

Primary Details Time Type

Full time Worker Type: Employee Medical Coding, or Injury Coding, is a regulated and audit-exposed activity. Coding accuracy directly impacts claim outcomes, reserving, actuarial modelling, and regulatory reporting, requiring specialized skills and formal accreditation.

Primary Responsibilities

• Review and interpret medical reports, certificates, hospital records, and clinical documentation to identify relevant diagnoses and injuries Accurately assign standardized medical or injury codes (i.e AIS or equivalent framework) in line with regulatory and internal guidelines
• Complete initial, review and final coding within prescribed service level agreements and regulatory timeframes
• Participate in all relevant meetings in order to share and develop strategy, knowledge and best practice
• Ensure current knowledge and adherence to relevant Motor Accident Authority legislation, government and Company guidelines
• Liaise with internal and external network to obtain relevant information Accumulate data in order to identify the type and severity of injuries sustained in motor vehicle accidents

Required Education

Graduates of medical allied courses preferably Nursing, Physical Therapy

Required Experience

Insurance injury coding Trauma registries Health or claims environment using standardized injury classifications Preferred Competencies/Skills Claims handling exposure Interpreting poorly structured and handwritten medical certificates Applying coding accuracy under scrutiny Prioritizing complex cases under SLA pressure Communicating coding outcomes to claims handlers and onshore stakeholders Excellent verbal and written communication skills (English) Preferably with Case Management Skills Preferred Licenses/Certifications Abbreviated Injury Scale (AIS) certification is preferred but can also be taken as part of training.

US Only - Disclaimer

• To successfully perform this job, the individual must be able to perform each essential job responsibility satisfactorily. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential job responsibilities.

Job Type

• Individual Contributor Global Disclaimer
• The duties listed in this job description do not limit the assignment of work.

They are not to be construed as a complete list of the duties normally to be performed in the position or those occasionally assigned outside an employee’s normal duties.

Our Group Code of Ethics and Conduct addresses the responsibilities we all have at QBE to our company, to each other and to our customers, suppliers, communities and governments. It provides clear guidance to help us to make good judgement calls.

Skills

Analytical Thinking, Claims Administration, Claims Processing, Claims Resolution, Communication, Critical Thinking, Customer Service, Customer Value Management, Financial Advising, Intentional collaboration, Managing performance, Process Compliance, Process Improvements, Risk Management, Stakeholder Management How to Apply: To submit your application, click "Apply" and follow the step by step process.

Equal Employment Opportunity

QBE is an equal opportunity employer and is required to comply with equal employment opportunity legislation in each jurisdiction it operates.