Medical Coder OP/IP

Job Description

• Ensure documentation and billing compatibility according to the rule engine.
• Manage electronic claim submission processes.
• Monitor E-Prescriptions for accuracy and timeliness.
• Report day-to-day activities to the designated authority.
• Handle queries from other departments regarding medical coding.
• Coordinate with insurance companies to resolve E-Claim issues.
• Answer staff queries related to medical coding.
• Enter any missing codes to ensure completeness of the revenue cycle.
• Contribute to updating the Hospital Management System (HMS) with relevant codes and information.
• Liaise with approval, billing, and reconciliation teams for process completion.
• Follow management priorities on a daily basis.
• Support and strategize with the approvals team for efficient code-based approvals.
• Report service level auditing findings and monitor compliance with insurance protocols.
• Explore innovative strategies to enhance departmental performance.
• Monitor the rule engine for predictable claim rejections and take necessary actions.
• Ensure proper coding of diagnoses and procedures for accurate billing.
• Implement initiatives to improve the institution’s revenue flow.
• Manage denials effectively to minimize revenue loss.
• Supervise DRG activities according to Assistant Insurance Manager/Insurance Manager instructions.

Qualifications:

• Bachelor’s degree with a medical background.
• Certified coder
• 2+ Years of Experience in Healthcare.
• Excellent communication skills at all levels including excellent listening skills.
• Possess a strong working knowledge of Microsoft Office Suite including Internet Explorer, Outlook, Word, PowerPoint and Excel.
• Good verbal and written communication skills.

Applicants whose experience may not directly align with the position requirements may not be selected for further consideration.
Thank you for your understanding