Original posting on naukrigulf. You apply directly with the employer — we never auto-apply.
Job description
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• Analyzing and auditing of claims for completeness with relation to medical information and insurance coverage for services rendered.
• Communicate with physicians and other healthcare providers to clarify ambiguous or incomplete documentation to ensure accurate coding - Physician Query Process as and when required.
• Scrutinize claims for accuracy, completeness, and compliance with coding and billing standards before saving the bill.
• Collaborate with healthcare providers and clinical documentation improvement specialists to enhance the quality and completeness of medical records.
• Provide reports and analysis of coded data to support billing, compliance, and quality improvement efforts.
• Stay up to date with changes in coding guidelines and regulations and pursue ongoing education (CEUs) and certifications to maintain expertise in Inpatient coding.
• Understand the individual client payer contracts so as be able to process claims in submission and resubmission based on the same.
• Be able to process claims either in DC or IP scenario.
• Analyze and communicate coding and billing issue of the provider to the supervisors.
• Have complete knowledge of billing guidelines of the provider and payer.
• The Coder must undertake a thorough review of applicable documentation to assess the documentation requirement and determine the appropriate ICD-10-CM and/or CPT-4/USCLS codes to be reported, in conjunction with the applicable version of Official Guidelines
• Must observe AHIMA code of ethics while assigning relevant code sets.
• Applying the relevant code sets, keeping in mind the trends for denials and non-payments in relation to detailed data needed to describe and notify services as rendered within the Insurance scenario.
• To undertake any additional tasks assigned by the line manager in accordance with operational requirements.
• Follow the correct billing Rules as per the standard set by Authorities & Insurance companies
Bachelor in Life Sciences.
• Most relevant coding certification from AAPC (COC, CPC, CIC) or AHIMA (CCS, CSSP, CCA) as
accepted by the DHA/MOH.
• Proficiency in using coding software and Electronic Health Record (EHR) systems.
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