Medical Coder - Inpatient

Analyzing and auditing of claims for completeness with relation to medical information and insurance coverage for services rendered.

Communicate with physicians and other healthcare providers to clarify ambiguous or incomplete documentation to ensure accurate coding - Physician Query Process as and when required.

Scrutinize claims for accuracy, completeness, and compliance with coding and billing standards before saving the bill.

Collaborate with healthcare providers and clinical documentation improvement specialists to enhance the quality and completeness of medical records.

Provide reports and analysis of coded data to support billing, compliance, and quality improvement efforts.

Stay up to date with changes in coding guidelines and regulations and pursue ongoing education (CEUs) and certifications to maintain expertise in Inpatient coding.

Understand the individual client payer contracts so as be able to process claims in submission and resubmission based on the same.

Be able to process claims either in DC or IP scenario.

Analyze and communicate coding and billing issue of the provider to the supervisors.

Have complete knowledge of billing guidelines of the provider and payer.

The Coder must undertake a thorough review of applicable documentation to assess the documentation requirement and determine the appropriate ICD-10-CM and/or CPT-4/USCLS codes to be reported, in conjunction with the applicable version of Official GuidelinesMust observe AHIMA code of ethics while assigning relevant code sets.

Applying the relevant code sets, keeping in mind the trends for denials and non-payments in relation to detailed data needed to describe and notify services as rendered within the Insurance scenario.

To undertake any additional tasks assigned by the line manager in accordance with operational requirements.

Follow the correct billing Rules as per the standard set by Authorities & Insurance companies Bachelor in Life Sciences.

Most relevant coding certification from AAPC (COC, CPC, CIC) or AHIMA (CCS, CSSP, CCA) asaccepted by the DHA/MOH.Proficiency in using coding software and Electronic Health Record (EHR) systems.