OP Medical Coder

• Follow the mandatory SOP, checklist and relevant payer and coding guidelines. • Checking demographic details of patient and make sure the front desk should select the proper regulatory policy (DHPO or RIAYATI) • Proper documentations are entered in the Chart/ EMR/ Claim form by the doctors. • Supporting details/ justification available in EMR of all investigation done. • Checking all CPT codes entered are correct based on CPT guidelines. • Checking excluded ICD and CPT based on Coding guidelines. • Approved services and rendered services are match. • Ensuring all requested investigations are done and invoiced. • Check the claim with correct Receiver and Payer name before finalizing the bill. • Check the claim with correct Patient Copay application. • Ensure all claims are submitted to insurance company. • Check the payer’s name, rate plan and plan name selected properly. • College Bachelors or Diploma in any medical discipline or related fields • Coding Certification, CPC – Certified Professional Coder (AAPC) • Proficiency in ICD-10-CM (diagnosis codes) • Proficiency in CPT (procedure codes) • Knowledge of HCPCS Level II (supplies, equipment, services)