Medical Coder

Job Description

The post holder will interpret patient medical records, transcriptions, test results, and other documentation into codes that insurers use to process claims from patients. The Medical Coder is responsible for reviewing and analyzing medical records to assign the appropriate ICD-10-CM and CPT codes for a variety of medical services and ensure to a smooth billing process.The medical coder should also be instrumental into our revenue cycle management and be responsible to find ways to improve our revenue from insurance by formulating strategies to increase our revenue.

Coding

• Manage high-quality of timely coding of diagnoses and procedures for outpatients accounts.

• Work in close collaboration with healthcare providers, medical billers, and insurance companies to ensure proper reimbursement and compliance.

• Implement strategic policies by selecting methods and evaluation criteria for accurate results.

• Make corrections to draft reports after Therapists and Doctors, review and re-submit approved reports to managers in a timely manner.

• Making sure that insurance billing codes are assigned correctly and sequenced appropriately as per government and insurance regulations

• Collaborate with all healthcare providers to clarify medical documentation and coding discrepancies

• Maintain confidentiality of patient and healthcare information

• Assist in claims & medical audits and documentation reviews

• Ensure all claims are submitted in a timely manner and monitor the progress of submitted claims

• Address any issues, such as claim denials by resubmitting corrected claims or appealing denials when necessary as well as in reconciliation level

• Stay up to date on insurance coding updates, regulations, circulars, and industry also have the responsibility to finds strategies and processes to improve and increase our revenue from insurace

Coding

• Accurately follows coding guidelines and legal requirements to ensure compliance with DOH /DHA / DHCC or other applicable regulatory bodies.

• Ensures the accuracy and timeliness of required code assignments.

Patient Experience & Calls

• Answers telephone, enquires promptly, and politely supports the patient’s query on all insurance related matters.

• Undertakes daily administrative duties as required within the Clinic to ensure the efficiency of patient flow.

• Provides a high standard of patient support services with attention to detail for service delivery experience.

Requirements:

• Diploma or Bachelor’s Degree
• Certified Professional Coder or Certified Coding Specialist
• At least 2 years’ experience in Billing or Insurance within a clinic/OPD environment on Reception, Call Centre, Patient Support services.
• Experience with CPQ and Compliance framework.
• Working knowledge of CPT, CDT, HCPCS, ICD-9 or 10 and DRGs.
• Working Knowledge in IT & Call Centre related Software Systems.