Insurance Executive
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Key skills for this role
About the Role
The role involves accurate coding, documentation evaluation, training coders, and ensuring compliance with guidelines in insurance claims management.
Key Skills for This Role
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Overview
- The incumbent checks and sequences the most accurate ICD-9/ ICD10- CM/CPT/HCPCS/DRG/Other codes for diagnoses and procedures for documented information.
- Assures the final diagnoses and operative procedures as stated by the physician are valid and complete.
- Abstracts all necessary information from health records to identify secondary complications and co-morbid conditions.
- Evaluates the record for documentation consistency and adequacy.
- Ensures that the final diagnosis accurately reflects the care and treatment rendered.
- Computes and gives the correct DRG coding all inpatients cases.
- Providing training and guiding other coders / Medical Records Technicians in coding, updating them with new coding rules and regulations as and when it is necessary.
- Analyzes doctors’ documentation to assure the appropriate Evaluation &
- Ensures coding is as per HAAD guidelines and regulations.
- Provides feedback to Doctors regarding coding errors or oversights.
- Constantly updates to the latest coding versions and HAAD coding directives.
- Management (E & M) levels are assigned using the correct CPT code.
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