Medical Coder with RCM experience
To process with the highest quality as per the set targets the bills/claims generated on credit base for submission to insurance companies and private payers. The processing includes (but not limited to) coding, data entry, eligibility check, benefits check, insurance rules compliance, regulations compliance and general screening.
Requirements
Graduate with a Tertiary Diploma or Degree will be an advantage along with Medical Coding Certification (CPC).
Previous experience in accounts/Billing (Hospital) related field
Above average computer literacy and a good working knowledge of Microsoft Office.
Demonstrated ability to written and oral in English
Demonstrated ability to work in a multi-cultural team
Medical terminology and coding certification (CPC)
Key Outputs
Responsible for screening of invoices for accuracy of discounts/coding/eligibility/non-covered services/compliance to regulatory and insurance rules/accurate approvals are attached (where applicable. Bills are sorted by insurance company, screened and missing information completed as per set standards in coordination with billing cashiers, doctors, nurses and ensuring that patient information confidentiality is maintained. Cashiers/Doctors intimated on non-compliance.
Claims dispatched to insurance companies within the stipulated period set by the management.
Dispatch, collection and disallowance reports are prepared and analysed. Ensure that system is updated with payments and dispatched bills.
Age analysis report is utilized to identify outstanding balances.
Ensures that rejected amounts are allocated as per standard procedure, Resubmit disallowed bills within stipulated period to different insurance companies. Final reconciliation statement is prepared within the stipulated
Requirements
Graduate with a Tertiary Diploma or Degree will be an advantage along with Medical Coding Certification (CPC).
Previous experience in accounts/Billing (Hospital) related field
Above average computer literacy and a good working knowledge of Microsoft Office.
Demonstrated ability to written and oral in English
Demonstrated ability to work in a multi-cultural team
Medical terminology and coding certification (CPC)
Key Outputs
Responsible for screening of invoices for accuracy of discounts/coding/eligibility/non-covered services/compliance to regulatory and insurance rules/accurate approvals are attached (where applicable. Bills are sorted by insurance company, screened and missing information completed as per set standards in coordination with billing cashiers, doctors, nurses and ensuring that patient information confidentiality is maintained. Cashiers/Doctors intimated on non-compliance.
Claims dispatched to insurance companies within the stipulated period set by the management.
Dispatch, collection and disallowance reports are prepared and analysed. Ensure that system is updated with payments and dispatched bills.
Age analysis report is utilized to identify outstanding balances.
Ensures that rejected amounts are allocated as per standard procedure, Resubmit disallowed bills within stipulated period to different insurance companies. Final reconciliation statement is prepared within the stipulated
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