Medical Coder
Prime Healthcare Group
مجموع سنوات الخبرة :16 years, 10 أشهر
• Managing of all outpatient coding through accurately assigning ICD-10-CM and/or CPT-4 code(s) and sequence diagnosis and procedures per patient medical record.
• Ensure coded data accurately reflects service provided, based on documentation complying with DHA guidelines.
• Conducted training, in-service and other education regarding diagnosis, procedure code assignment, DHA regulatory requirements for compliance and data quality for doctors and other healthcare professionals.
• Processed claim forms, adjudicates for provision of deductibles, co-pays, co-insurance maximums and provider settlements.
• Identify issues resulting in non-payment of claims due to internal and external issues by closely assisting with receipt allocation and claims resubmission team to resolve problems regarding claim settlement.
• Assist the Network Department in creating proposals and cost-estimates, conducting technical evaluations and recommendations, as well as summary budget forecasting.
• Serve as the point of contact for the company's providers for orientation, ongoing training, and technical support.
• Update provider agreements with the existing network, train for necessary changes and monitor the abidance in coordination with the Claims Department Manager.
• Effective communication with doctors regarding proper ICD/CPT code assignment.
• Effectively transitioned process of HIM/Coding according to HAAD Standards in UAE.
• Coding and billing for multi specialties including Internal Medicine, Family Practice, OBG/GYN, ENT, Radiology, and Gastrointestinal services.
• Use of 3M encoder and work closely with coding medical disease/injury diagnoses and procedures on inpatient and outpatient charts, ensure diagnoses and procedures meet current coding requirements.
• Ensured records met quality and risk-management requirements by participating in hospital chart review committee.
• Pull patient charts and file back when needed, updating patient information as well as insurance verification, and answer phones.
• Sustaining effective communication with the superior coders with a view to get acquainted with the modern coding updates and forthcoming guiding principles
• Observing the quality parameters regularly and ensuring that the quality of coding work is maintained at a higher rate
• Written communications: Microsoft Office: E-mail (Outlook), trip reports (Word), time reporting (Excel), and internal and external presentations (Power Point).
Verify accuracy of patient information such as name and identification number; verify accuracy of transcription for correct punctuation, grammar, and spelling.
Drafted procedural manuals and job descriptions for the records department.
Transcribed detailed medical reports. Edited sentence structure to clarify meaning and protect the organization from litigation.
Increased word processing productivity by creating macros and using customized abbreviation software.
Responsible for training of new employees from basic level of medical transcription and introduction of several transcription platforms.
Operate personal computer to compose and edit correspondence and memoranda from dictation, verbal direction, and from knowledge of established department/division policies; prepare, transcribe, compose, type, edit, and distribute agendas and minutes of meetings.
Prepare and maintain weekly attendance and annual vacation records on departmental employees.
in