Job Description

Responsibilities:

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.