Medical Coder - Inpatient

Responsibilities

• Analyzing and auditing of claims for completeness with relation to medical information and insurance coverage for services rendered.
• Communicate with physicians and other healthcare providers to clarify ambiguous or incomplete documentation to ensure accurate coding Physician Query Process as and when required.
• Scrutinize claims for accuracy, completeness, and compliance with coding and billing standards before saving the bill.
• Collaborate with healthcare providers and clinical documentation improvement specialists to enhance the quality and completeness of medical records.
• Provide reports and analysis of coded data to support billing, compliance, and quality improvement efforts.
• Stay up to date with changes in coding guidelines and regulations and pursue ongoing education (CEUs) and certifications to maintain expertise in Inpatient coding.
• Understand the individual client payer contracts so as be able to process claims in submission and resubmission based on the same.
• Be able to process claims either in DC or IP scenario.
• Analyze and communicate coding and billing issue of the provider to the supervisors.
• Have complete knowledge of billing guidelines of the provider and payer.
• The Coder must undertake a thorough review of applicable documentation to assess the documentation requirement and determine the appropriate ICD 10 CM and/or CPT 4/USCLS codes to be reported.
• Must observe AHIMA code of ethics while assigning relevant code sets.