Education : Degree in any related fieldpreferably life science background. CCS (AHIMA) or CPC (AAPC)certification is required.
Duration and typeof Experience : Minimum of three (3) years Outpatient codingexperience in any setting i.e., hospital, clinic, or other relatedhealthcare field is required.
In addition to medical coding,knowledge of billing process will be a plus. Both inpatient andoutpatient experience preferred.
Candidateswith Abu Dhabi hospital coding experience preferred
Job functions and KeyAccountabilities :
Expertise in medical record review to abstractinformation required to support accurate Outpatientcoding
Expertise in assigning accurateICD-9-CM, CPT, DRG, HCPCS and other service codes for diagnosis andprocedures performed in the Outpatient setting.
Applying advanced knowledge of medical terminology ,anatomy and physiology, treatment modalities , diagnostic test,medications
Adhere to the HAAD Claims andAdjudication rules and coding guidelines
Actsas a resource when necessary for billing, pre-authorization andreimbursement issues and Inpatient coding.
Excellent interpersonal skills while interacting withphysicians, nurses and other staffs.
Be amentor for the team members and work with team to ensure high levelof accuracy.
Ensure high level of patient dataconfidentiality.
Knowledge on Diagnosisrelated grouping
Aware of current trendsrelated to medical necessity , DRG and HAAD Claims and Adjudicationrules and coding guidelines
Utilizes toolsavailable in 3M to ensure accurate coding.
Ensure knowledge on deductibles, co-payments,co-insurance amounts, insurance exclusions and other policies ofall insurances that Oasis Hospital is dealing with.
Critical thinker with ability to perform root causeanalysis, prepare and implement action plans and lead improvementinitiative.
Query physician for clarificationand additional documentation prior to code assignment.
Perform other related duties incidental to the workdescribed herein.
Ensuresappropriate selection of principal diagnosis, qualifying secondarydiagnosis, Impacting procedures, accurate E / M and others serviceswhich is relevant for submission and reimbursement.
Effective physician query process prior to codeassignment to obtain greatest possible diagnostic specificity andclinical documentation to accurately reflect the patient'scondition.
Consistently maintain quality andproductivity standards and achieve the productivity target withdesired quality of 90%.
Ensures to reducerejections and get the claim paid at the initial submission ofclaims.