Responsible for coding charts per CMS guidelines to include CPT, ICD, HCPCS, Modifiers before submitting to clients.
Analyse and interpret patient medical record and demographic information to identify and determine the amount and nature of billable services as per third party payer requirements.
Research and resolve enquiries from clients and stakeholders about the right codes.
Partner and support leaders on continuous process improvement opportunities to include quality improvement and productivity improvement initiatives.
Keep oneself abreast with the latest updates and changes and/or new regulations in the coding domain through conferences, workshops, and in-house sessions.
Generate reports on pending queues.
Support team on an as required basis in audits on specific parameters.
Provide proactive support to analyse/review feedback reports.
Provide insights to the training team in planning training for the coders.
Should take active participation in Innovation and Automation initiatives with Team managers.
Qualifications
- BPT, BSC Nursing, MSC Nursing, B Pharm, M Pharm, BOT, Life Science is a preferred.
- CCS/CPC/COC certification is a must
Functional Competencies & Role Prerequisites:
- A minimum of 3 years and above experience in the coding domain which includes Multi speciality is a must.
- Should open to work in rotational shifts.
- Should be conversant with core coding guidelines and best practices with strong knowledge of NCCI edits,
local and national policies (CMS guidelines).
- Positive Comprehension Skills
- Detail Orientation, Coaching and Feedback Skills
- Typing Skills - Minimum expectation of 35 - 45 words per minute.
Behavioral Competencies:
- Team Work
- Achievement Orientation
- Communication
- Analytical Skills.