Medical coder/Insurance Coordinator
Samaya Specialized Center
مجموع سنوات الخبرة :12 years, 10 أشهر
• Daily verification and checking of invoices for outpatient and inpatient medical claims. • Daily documentation maintenance and review of the patient’s Electronic Medical Record utilizing the Health Information System. • Assigning of accurate ICD-10 CM code for the diagnosis/es at the highest specificity with proper selection of the Principal diagnosis. • Billing the CPT and HCPCS level II codes for procedures/service rendered. • Creates XML files & Final checking of XML files for uploading to Green Rain for claims submission. • Accurately follows coding guidelines and legal requirements to ensure compliance with Health Authority Abu Dhabi (HAAD) adjudication. • Processing the pre-approval requirements and verification of authorization surgery requests before sending to the Insurance Company for approval. • Receive pre-authorization approvals from insurance companies and resend denial queries. • Providing justifications for denial codes for Resubmission and Reconciliation Process.
• Direct reporting to the General Manager for overall operations of the company.
• Provide full personnel assistance work to General Manager that meets the needs of standards & procedure of the company that maintain its confidentiality.
• Prepare & provide comprehensive reports in behalf of the General Manager.
• Responsible for Internal Auditing for ISO compliance.
• Responsible for visa preparation & formalities such as Residence visas of employees, mission visas for engineers, visa applications to various embassies concerning the travel arrangement of the General
Manager.
• Responsible for the application of Security Pass, ADMA and ZADCO Travel Card for Engineers.
• Responsible for the application and renewal of medical insurance for employees.
• Responsible for the reimbursement claims for the employee.
• Organize and coordinate meetings, minutes of meetings, diaries, events and travel arrangements for the General Manager, Technical Manager and BDM.
• Maintain petty cash / reports for office & miscellaneous expenses.
• Responsible for recruitment/ advertising & conducting interview.
• Hotel and Airline reservation/booking for the managers and to some guest as per advice by the management.
• Event Coordinator such as Workshop Trainings/ Seminars/ Exhibitions, etc.
• Prepare Appointment Letters/ Contracts as per management advice.
• Making sure that buildings meet health and safety standards and legal requirements.
• Organize Health Programs such as Health and Wellness, Vaccinations, Drug Testing Annual Physical Examination for employees and provides excellent First Aid facilities.
• Manages employee’s benefits regarding health such as HMO and Medical reimbursement.
• Reviewing and analyzing insurance premiums.
• Managing general cleaning and maintenance.
• Managing the security procedure and monitory security system.
• Adhering to requirements of the occupational health and safety guidelines and infection control guidelines.
• Actively leads the First Aid Team of the company.
• Implements the recruitment process.
• Works with HR Officer to develop job description.
• Implement the new employee orientation processes.
• Drafts, edits and proofreads company policies and procedures and related documents.
• Assists with the development/implementation of performance evaluation and rewards systems.
• Explains company compensation and benefit programs.
• Coordinates with the implementation of Human Resource Information Systems (HRIS).
• Ensure accuracy and timeliness of employees’ daily time record.
• Facilitate monthly remittances to government agencies.
• Designing and expanding training and development programs.
• Arranges for employee physical examination, first aid and other health related programs.
• Evaluating training and development program.
• Assisted employees in sorting their issues related to work.
• Attends conferences and meetings, as employee-management liaison
• Manages the implementation of medicine inventory and issuance policy of the plant.
• Manages the implementation of medical management and health and wellness program of the plant.
• Ensuring that employees are declared "fit to work" before they are allowed to report back at their respective work area.
• Organize the annual physical examination, pre-employment medical exam and other laboratory
diagnostics test for employees.
• Actively leads the First Aid Team of the company.
• Keeping of medical records and preserving confidentiality of all records.
• Assesses occupational health problems in the company.
• Accurate and timely delivery of monthly and annual reports concerning employees health and welfare.
• Coordinates function in the maintenance of environmental sanitation.
• Establishes canteen committee, first aid committee and committee against drug addiction and act as its secretariat.
• Manages health benefits of employees like HMO and medical reimbursement.
• Prepares and conduct benefits orientation.
• Ensures that employees’ personal records are updated.