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.