Clinical Coding officer
Sheik Khalifa Medical City
Total years of experience :16 years, 6 months
Participating in clinical documentation improvement (CDI) practice through effective communication with physicians and other healthcare professionals and help them to document more specific diagnoses & procedures for quality coding and proper reimbursement.
Working closely with revenue recovery specialists and help them to improve Denial Management process by properly answering queries and clarifying doubts.
Periodically participating CERNER Application Software & Clinical Coding Training.
Actively participating JAWDA Clinical Coding audit preparation & training.
Assign ICD-10-CM, CPT-4 Codes for Inpatient admissions and compute accurate DRG by using CC and MCC conditions most effectively to get maximum reimbursement to the hospital.
Assigning ICD-10-CM, CPT, HCPCS & E&M codes for Day-surgery & Observation records
Coding for Long Term Care admissions.
Resubmitting denied claims by properly answering the denial reason according to coding, payer guidelines & contract policies with appropriate documents.
Responsible for daily operations of Coding & HIM Department in monitoring production and quality.
Successfully managed a team of more than 18 staffs which includes 12+ coders and 6+ HIM staffs.
Managed administration of personnel, including interviewing, hiring, evaluating, and coaching of employees.
Successfully managed Coding Compliance Audit by DOH, Abu Dhabi and periodical Insurance payer audits, properly answered queries, sends feedbacks, presents it to the management according to the clinical coding, insurance payer & contract guidelines.
Created a Clinical Documentation Improvement (CDI) practice in the hospital through working with physicians and other healthcare providers for more specificity of diagnoses & procedures for reimbursement, compliance with hospital policy, JCIA and DOH standards
Conducted periodical audit for Inpatient charts by abstracting clinical information from various clinical charts against the codes given by coders, sends feedbacks & presents the results to improve coding.
Conducted periodical audit for Outpatient claims and Evaluation and Management Coding.
Identify, Implement and maintain Key Performance Indicators (KPI) of the dept.
Design and implement minimum data sets for various medical record forms (JCIA STD.)
Training and orientations to new physicians & other providers about Documentation, Clinical Coding and Insurance, periodically update them new trends in the process.
Assign ICD 9-CM, CPT, HCPCS codes and compute DRGs for Inpatient admissions.
Working as aSenior Medical Coder with Ahalia Medical Group (JCIA), Abu Dhabi, UAE from April 2011 to the present.
Job Profile:
➢ Assigning ICD-9-CM, CPT and HCPCS codes for Outpatient visits.
➢ Assign DRG Codes for Inpatient admissions.
➢ Communicate with physicians and help them to Improve documentation and better reimbursement.
➢ Always comply with HAAD rules and regulations regarding Health Information, Coding and Reimbursement.
➢ Duties also include handling wide variety of medical claims including primary care and surgeries, diagnostic testing, ER, and E&M.
➢ Processed payments, made deposits, and performed other general office duties.
Worked with Apollo Health City (JCIA), Hyderabad, India as Junior Executive, Health Information Management, from January 2009 to April 2011.
Job Profile:
➢ Management of HIM (Medical Records) Department.
➢ Medical Coding. (Diagnostic and Procedural) using ICD -I0 and ICP (Statstical Classification)
➢ Closed and open review of Clinical Documentation for the survey of Joint Commission International Accreditation (JCIA) and Acute Stroke Program (JCIA)
➢ Qualitative and Quantitative analysis of documentation of Inpatient Medical Records.
➢ Reporting of Hospital Statistics to Senior Executive-HIM.
➢ Maintenance of Medico Legal Cases and Registers.
➢ Maintain rules & regulations regarding Confidentiality.
➢ Provide Orientation and training for medical record staffs.
➢ Participated in JCI Re Accreditation (April2009)
➢ Participated in JCI Acute Stroke Program ( April 2009)
Medical Documentation Medical Record Science Classification System in Medicines(ICD-9CM, ICD-10 CM, CPT, ICP, ICD- O) Reimbursement Methodology Anatomy & Physiology Pathology & Microbiology Pharmacology & Medical Bio-Chemistry Medical terminology. Hospital Statistics Administration of HIM Department Health Information Security Confidentiality of Health Information Medico legal cases Information Processing National & International Documentation Centers Information Technology (IT) in Medicines.