Rcm Administrator

2 weeks ago

Sharjah, Sharjah, United Arab Emirates NMC Healthcare Full time
Manages Claims Submission by checking accuracy of CPT and ICD coded invoices.

  • Rectifies errors in billing in coordination with the doctors.

Claims Processing Team:
Submission

  • Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF / discharge summary for submission to various insurance companies on daytoday basis.
  • Analysis of the UCF documentation issue from time to time and providing reports about areas of concern in coding and the claims.
  • Uploads OP Eclaims.
  • Identifies commonly used ICD codes and relevant CPT codes and compile the list.
  • Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable).
  • Reports variations / irrelevance in the CPT codes used for services/procedures.
  • Assigns proper CPT/ HCPCS codes for newly added services / procedures.
  • Reports the audit findings about discrepancies in the claims daily.
  • Be available to the Consultants about clarification regarding the ICD/ CPT codes. Coordinates with Insurance Doctors and Billing Supervisor/ Accountants for E claim Submission, Resubmission, Follow Up and Final Sign off.
  • Claims Processing Team: Resubmission
  • Coder is required to review documentation by the physicians in the UCF / E
  • Discharge summary and look for discrepancies between the documentation and the coded, diagnosis and selected CPT codes.
  • Senior Coder required to overview the notes prepared for UCF / Discharge Summary have all the required information. In case any information is missing they need to contact the physician and get it filled.
  • Be available to the Consultants about any clarification regarding ICD/CPT codes.
  • Senior Coder is required to speak to clinicians about specialty specific rejections and reasons for the rejections and how to avoid such rejections.
  • Bachelor's degree from an accredited college / university. Bachelor's degree in nursing, pharmacy, physiotherapy etc. will be preferred. Certification from AAPC / AHIMA is a must.
  • Minimum 2 years' experience in a similar environment and similar role
  • Proficient in ICD 10, CPT 4 coding conventions.
  • Knowledge of relevant software system such as MS Office, particularly Excel.
  • Good Experience in Coding of Inpatient and Outpatient claims for Billing & Reimbursement purposes.

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