Medical Coder
Taiba Hospital
Total years of experience :11 years, 11 Months
1. Generate a daily report for coding outpatient claims from SHMS and allocate to the coders on daily
basis.
2. Prepare daily discharge summary and send to medical records.
3. Internal weekly audit is done for quality purpose.
4. Claims with administrative deficiencies will be endorsed to the Patient Access Supervisor for completion.
5. A daily feedback report will be sent out to the Patient Access Manager for process development.
6. Coded claims are endorsed to data entry team concurrently listing patient file number in an excel sheet for acknowledgment via email.
7. Incomplete and or inconsistent claims will be sent to physicians for clarification and completion by the coding staff.
8. Generate a daily report from SHMS and verify each file number in the lab and radiology module to check all diagnostics are carried out. If they are in pending status, the reception module will be checked for invoiced amount, invoice number, type of investigation, and file number, and an email notification will be sent out to Patient Access Manager for canceling such an invoice.
9. Audit patient charts for verification of documentation including electronic medical records to continue to build increase revenue.
INPATIENT CODING
1. Coding infusion/hydration/IVP/IM administrative charges for IPD patients.
2. Generate OT list for coding Inpatient claims from SHMS on daily basis.
3. Audit daily IPD claims done against the system generated OT list.
4. Any changes in pre-approved procedure vs. procedure done, the physician is queried to write a re-approval form with a justification note and duly completed form then sent to the Insurance team for further action.
5. Upon receiving approval from the insurance company, an email notification will be sent out to the IPD office for correction of invoice.
6. Compile a list of surgeries done by departments every month for statistics. Verify pre-approved procedure name, procedure name in the operative report and procedure name on the invoice are all same.
7. Weekly insurance report from SHMS will be generated to compare it against the daily coded database to ascertain all claims that were generated are received and coded. An outstanding claims report will be prepared and sent to the Patient Access Manager every week for reconciliation.
8. Extracting relevant information from patient records.
9. Liaising with physicians and other parties to clarify information.
10. Examining documents for missing information.
11. Assigning CPT, HCPCS, ICD-10-CM, and ASA codes.
12. Assigning DRG codes if required.
13. Ensuring documents are grammatically correct and free from typing errors.
14. Advising and training physicians and staff on medical coding.
15. Ensuring compliance with medical coding policies and guidelines.
E/M and radiology.
•Supplies correct ICD 10 diagnosis codes on all diagnosis provided.
•Supplies correct HCPCS and CPT codes for all procedures and services performed.
•Identify mistakes in reports and check with doctors to obtain the correct information.
•Worked as
Responsibilities: -
•Worked as
to GIG portal, putty software, Coderyte, Citrix, Advocate software, MediTech, 3M, SHMS. •Exposure to SHADE, UNICARE, AND INSTA for coding, submission, remittance.