GlobeMed Group, the largest Healthcare Benefits Management company in the MENA region is looking for a Medical Doctor to assist in the setup and upkeep of the medical rules dictionaries as well as in the know-how transfer of Medical Expert System to all GlobeMed operations.

Duties & Responsibilities:

Preparing and maintaining automated medical rules based on the different versions of coding lists: ICD9, ICD10, ICD10-M, ICD10-CM, CPT4, ACHI, HCPCS, and DRGs (used for billing)...
Setting-up and maintaining all the dictionaries based on the different healthcare programs at all GlobeMed operations; as well as overall updates and changes in case of new requests and in case of any new emerging coding system(s).
Preparing and deploying General Exclusions dictionaries for proper policy implementation at all GlobeMed Operations.
Updating the process of existing dictionaries in case of new emerging coding list(s) or enforced requirements by regulators in operations.
Preparing and maintaining all IN- & OUT-Hospital Medical Expert Systems algorithms & dictionaries (including clinical pathways) for all GlobeMed Operations.
Performing testing of Medical expert system rules to monitor quality and appropriateness through Quality Assurance process.
Responding to any daily requirements of the operations (i.e. remove, add, update, and inquire about available info...).
Collecting medical requirements from operations and share those with the Medical Rules team unit for proper follow-up and process.
Identifying problematic areas in the actual processes used and reports back to the Medical Rules team unit for corrective measures and process for re-engineering of some of the rules.
Providing disease coding support in various applications.
Maintaining confidentiality of all prepared dictionaries.
Reading and studying allocated Manuals and following the corresponding certification process.
Ensuring effective team communication throughout the Medical Rules Unit.

Qualifications

Medical Doctorate, with official registration at the Lebanese Order of Physicians (LOP)
preferred to have knowledge of the medical coding procedure and the different coding systems and standards: ICD9-CM, ICD10, ICD10-AM, ICD10-CM, CPT4, ACHI and DRGs...
Computer literate with good MS Office skills
Fluent in English and Arabic, French is an asset
Good written and oral communication skills
Good organizational and follow-up abilities
Inquisitive and meticulous about details
Confidentiality