Medical Coding E/M OP

3 days ago

Chennai, Tamil Nadu, India Accumed Full time ₹ 5,00,000 - ₹ 8,00,000 per year

JOB DESCRIPTION

Associate, Coder

Job TitleAssociate, Medical Coder (OP)Job FamilyOperationsExternal Job TitleCoder, OP Coder, Medical Coder (OP)Exempt StatusNON-EXEMPTCareer Framework LevelBST1Reporting ToTeam Leader, CodingJob Family Summary:

The Operations Department is responsible to manage all aspects of claims management including Onsite operations and back-end processing. The department primarily works on main objective of submitting the claims in time with highest quality to ensure the client receives the payment with minimal or no rejections.

Role Summary:

Medical Coding is the process where the medical record and claim documentation are checked and medical diagnostics, treatments and procedures (medical services) are converted to universal alphanumeric ICD/ CPT/ HCPCS codes. This is one of the intermediate steps in processing claims. These codes form part of data collection which is used in research, funding and healthcare planning

The Associate Coder is responsible for applying the relevant coding to the claims based on the individual providers manual and as per the coding rules governing the specific compliance in relation to coding guidelines for the specific geographical area.

Primary Responsibilities:

  • The Coder must undertake a thorough review of applicable documentation to assess the documentation requirement and determine the appropriate ICD-10-CM/ CPT/HCPCS codes to be reported, in conjunction with applicable version of ICD/ CPT Official Guidelines
  • Must observe AMA/ CMS code of ethics while assigning relevant code sets. Reviewing patient medical records and assigning appropriate ICD/CPT/HCPCS codes with relation to medical information and insurance coverage for services rendered.
  • Applying medical coding guidelines with relevant code sets. Aware of denials and non-payment of services in relation incorrect coding.
  • Understand client specific coding guidelines and periodic updates to process the claims in timely manner.
  • Should be able to process multispecialty aspects of Out Patient coding (e.g. E&M, Surgical coding, etc.).
  • Analyze and communicate coding and billing related issue of the healthcare provider to the team leaders.
  • Have complete knowledge of medical coding and billing guidelines
  • To assist with documentation review and raise queries on completeness of patient medical records

Job Requirements:

  • Bachelor in Life Sciences or from Para-medical background
  • Active coding certification with updated membership either from AAPC or AHIMA
  • Minimum of 2 years of experience in medical coding and good knowledge of claims processing.
  • UAE experience and multi-specialty coding experience will be an added advantage

Key Performance Indicators (KPI's)

  • Meeting the set targets for processing the OP claims
  • Meet the client set KPI for quality and initial rejection rates
  • Maintain 95% of quality in coded claims.

Restricted for internal use only DOC# ACCUMED-UAE/Template/HRA-HRM/7060

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