Coding Auditor- Medical Coding
- Harris - Bizmatics
- 3 - 7 years
- Mumbai
- 2 months ago
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Job Description
Below is the JD:
Interested candidate can share cv on po**a@ha***********r.com
Looking candidate From US healthcare, RCM Only
Role & responsibilities: :
- Monthly audits for providers and mid-levels and coders to ensure documentation supports billing and provides feedback to drive improved documentation practices.
- Provides resolution to coding questions.
- Assist with provider questions and presents coding concepts to drive improved documentation practices
- Identifies coding trends and areas of risk
- Handles escalated coding questions because of claim denials
- Communicates adverse trends related to coding denials
- Research coding topics and LCDs to ensure compliance with payor requirements and payer specific guidelines
- Provide documentation training to providers and support staff as needed
- Reviews records for audit requests related to RAC audits, SRMC audits, prepayment reviews, etc. prior to appeals or other documentation being sent
- Manages unbilled patient encounters for office, ASC, hospital, and Pathology.
- Provides scrub claim logic for clean electronic submission to clearinghouse
- Protect the security of medical records to ensure confidentiality is maintained.
- Creates and/or updates the patients demographics and insurance information for new and established patients.
- Other duties as assigned
Requirements:
- CPC Certified (Required)
- 3+ years of experience in a clinic setting (Preferred)
- Preferred experience in Spine, Orthopedic or Pain Management
- Knowledge of CPT and ICD-10 codes
- Overall knowledge of business office procedures and policies (required)
- Thorough knowledge of third-party payers, HMOs, PPOs, Medicare and Medicaid.
- Ability to work independently with minimum supervision
- Correct coding for diagnosis and procedures
- Rely on experience and judgment to plan and accomplish goals.
- Strong troubleshooting and problem-solving skills
- Methodical and detail-oriented
- Organized
- Effective writer and oral communicator
- Ability to multi-task
- Production-minded
- Strong work ethic
Job Classification
Industry: BPM / BPOFunctional Area / Department: Healthcare & Life Sciences,
Role Category: Health Informatics
Role: Medical Biller / Coder
Employement Type: Full time
Contact Details:
Company: Harris - BizmaticsLocation(s): Mumbai
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Keyskills: Coding CPT CPC US Healthcare ICD Medical Coding
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₹ -8 Lacs P.A
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