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 day-to-day 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 E-claims. • 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.
اطلب مساعدة الخبراء لكتابة سيرة ذاتية مميزة.