Clinical Documentation Improvement Specialist

3 hours ago

Chennai, Tamil Nadu, India beBeeExpert Full time ₹ 18,00,000 - ₹ 25,00,000
Job Description

The Senior Claims Processing Specialist oversees all aspects of charge creation and capture, ensuring accurate and compliant billing practices. This role acts as liaison for clinical areas and revenue cycle on proper documentation, coding, and billing procedures.

This specialist plays a critical role in maximizing revenue integrity, minimizing denials, and ensuring compliance with payer regulations.

Key Responsibilities:
  • Oversee the process of charge creation, ensuring accurate and timely capture of all billable services.
  • Review encounter documentation (e.g., progress notes, orders, procedures) to verify that charges are supported and appropriately coded.
  • Identify and correct any errors or omissions in charge capture.
  • Monitor charge lag and implement strategies to reduce delays in billing.
  • Ensure that all charges are compliant with coding guidelines (CPT, HCPCS, ICD-10) and payer regulations.
Collaboration and Audits:
  • Liaise with clinical teams (physicians, nurses, etc.) to understand clinical workflows and documentation practices, ensuring accurate charge capture.
  • Collaborate with revenue cycle teams (billing, coding, AR) to resolve claim issues and improve overall revenue cycle performance.
  • Conduct regular audits of documentation and billing practices to identify areas for improvement.
  • Develop and implement corrective action plans to address identified deficiencies.
Reporting and Analysis:
  • Prepare reports on charge capture rates and accuracy.
  • Analyze data to identify trends and patterns in coding and billing practices.
  • Recommend process improvements based on data analysis.
Required Skills and Qualifications:

To be successful in this role, you will need:

  • Any Bachelor's degree or a related field preferred.
  • Minimum of 3-5 years of experience in medical coding, billing, or charge capture.
  • Knowledge of medical coding and billing regulations.
  • Excellent communication and interpersonal skills.
  • Strong analytical and problem-solving abilities.
  • Ability to work independently and as part of a team.
  • Excellent organizational and time-management skills.
  • Proficiency in using billing software and Microsoft Office Suite.
Benefits:

Our company values diversity, equality, and inclusion. We provide equal opportunities for everyone and recognize that our people are our strength. Our organization is committed to helping employees grow professionally and personally.

Others:

Our global collaborative of healthcare, operations, and IT experts creates innovative and sustainable processes for our clients. We aim to deliver next-generation solutions that enable our healthcare partners to provide positive experiences to their consumers.

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