Medical Coder for Home Care
Via Medica Intl
Abu Dhabi, United Arab Emirates
منذ 3 يوم
source : PostJobFree

Duties & Responsibilities :

Performing data entry of client information for billing

Generating, updating, and maintaining patient profiles for both current and new clients

Responsible for the submission of required reports for approval / re-approval while coordinating with supervisors

Demonstrating professional demeanor over the phone and providing customer service while making claim inquiries

Resolving patients’ complaints and concerns

Demonstrating strong attention to details and the ability to multi-task within a fast-paced work environment

Ensuring the completeness of all insurance forms and sub-forms

Providing high quality submissions at all times

Preparing and submitting claims for payment in a timely manner

Responding to inquiries regarding accounts

Posting cash receipts as received, if any

Completing accounts receivable and accounts payable reports

Monitoring accounts receivable and outstanding insurance claims

Maintaining a minimum balance in outstanding accounts

Preparing claims and reports as requested by management and as scheduled

Creating, maintaining, and updating billing manuals with new or changing rules and regulations

Attending provider billing training as needed for updates

Maintaining current expertise in billing and collections

Maintaining confidentiality of client and personnel information

Performing job functions in compliance with regulations and agency policies and standards

Tracking and cross-checking all forms, claimed amounts, level of care, duration of care, etc.

Performing other duties as assigned

Other Duties :

Audits records to ensure proper submission of services prior to billing on pre-determined selected charges

Receives hospital information to properly bill provider services for home care patients

Supplies correct ICD-10-CM 2015 diagnosis codes on all diagnoses provided

Supplies correct HCPCS code on all procedures and services performed

Supplies correct CPT code 2011 on all procedures and services performed

Contacts providers to train and update them with correct coding information

Attends seminars and in-services as required to remain current on coding issues

Audits medical records to ensure proper coding completed and to ensure compliance with regulatory bodies

Accurately follows coding guidelines and legal requirements to ensure compliance with regulatory bodies

Maintains all mandatory in-services

Maintains compliance standards in accordance with the Compliance policies and the Code of Conduct.

Reports compliance problems appropriately.

Determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete.

Quantitative analysis - Performs a comprehensive review for the record to assure the presence of all component parts such as : patient and record identification, signatures and dates where required, and all other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.

Qualitative analysis - Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered.

Reviews the records for compliance with established reimbursement and special screening criteria.

Analyzes provider documentation to assure the appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT code.

Qualifications :

Medical Bachelor Degree - BS Nursing preferred

Working knowledge of the billing process in a healthcare setting in the Emirate of Abu Dhabi

CPC - Certified Professional Coder or CCSPB-Certified Coder Specialist Physician Based

Minimum of 1 year experience in billing, in a Home Care setting

Must have a TASNEEF, JAWDA & DOH Audit exposure

Not less than two years medical coding experience post qualification in appropriate setting

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