- Handle information about patient treatment diagnosis and related procedures to ensure proper coding.
- Reading and analyzing patient records.
- Would be flexible working at Receptionist on managing the insurance and claims as well
- Interacting with physicians and assistants to ensure accuracy.
- Score medical condition and services for new and established patients.
- Follow up with insurance company regarding required reports or information.
- Determining the correct codes for patient records
- Prepare all reports and documents required by insurance company to grant preapproval as (collection and arrange the reports face to face consent form license of nurses physiotherapy & Doctor nursing care plan physiotherapy plan and assessment Scoring grid)
- Entering and coding patient services into a Daman Insurance system and generating approval letter for provided services.
- Submit claims to insurance and follow up to see if a claim is accepted or denied.
- Handles insurance claims and followup rejected claims.
- Reviewing and appealing denied and unpaid claims.
- Process payments from insurance companies.
- Working directly with the insurance company the patient and the medical staff to get a claim processed and ultimately paid.
- Provides information to patients and health care team by answering questions and requests.
- Filing and proper documentation of patients file
- Keeping track of patient data over multiple visits.
- Keeping track of patients hospital admission ER visits and discharges
- Maintains documentation of patient care services by auditing patient and department records.
- Arrange patients files and records.
- Internal audit of PMSs home healthcare documentations.
- Prepare and submit JAWDA KPI report.
- Collect and save all KPI reports.
- Maintaining patient confidentiality and information security
- Perform Coding Audit (Tasneef) and prepare all documents required for it.
- Ensuring compliance with DOH and TASNEEF quality standards
- Ensuring compliance with DAMAN requirements and standards
- Participates in policy making and decision making in relation to PMSs Rehab Center billing and coding practices
Qualifications :
Bachelors degree in related field preferred
Bachelors degree in medical related (Nursing Physician Physiotherapy )
Additional Information :
Mandatory Certification from CPC or CCS by AHIMA
2 years experience as a medical coder
Advanced understanding of medical terminology and administration processes.
Remote Work :
No
Employment Type :
Fulltime