Medical Coder - Outpatient

• 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 outpatient 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 OP/ER scenario. • Analyze and communicate coding and billing issues 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. 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.