Medical Coder, Receptionist

Job Responsibilities

• Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding.
• Read and analyze patient records.
• Be flexible working at Receptionist, managing insurance and claims as well.
• Interact with physicians and assistants to ensure accuracy.
• Score medical conditions and services for new and established patients.
• Follow up with insurance companies regarding required reports or information.
• Determine the correct codes for patient records.
• Prepare all reports and documents required by insurance companies to grant pre-approval.
• Enter and code patient services into a Daman Insurance system and generate approval letters for provided services.
• Submit claims to insurance and follow up to see if a claim is accepted or denied.
• Handle insurance claims and follow up on rejected claims.
• Review and appeal denied and unpaid claims.
• Process payments from insurance companies.
• Work directly with the insurance company, the patient, and the medical staff to get a claim processed and ultimately paid.
• Provide information to patients and the health care team by answering questions and requests.
• File and maintain proper documentation of patient files.
• Keep track of patient data over multiple visits.
• Track patients' hospital admissions, ER visits, and discharges.
• Maintain documentation of patient care services by auditing patient and department records.
• Arrange patient files and records.
• Conduct internal audits of PMS's home healthcare documentation.
• Prepare and submit JAWDA KPI reports.
• Collect and save all KPI reports.
• Maintain patient confidentiality and information security.
• Perform Coding Audit (Tasneef) and prepare all documents required for it.
• Ensure compliance with DOH and TASNEEF quality standards.
• Ensure compliance with DAMAN requirements and standards.
• Participate in policy making and decision making in relation to PMS's Rehab Center billing and coding practices.

Desired Candidate Profile

Qualifications

Bachelor's degree in a related field preferred, with a focus on medical-related fields (Nursing, Physician, Physiotherapy).