Client Partner - Medical Coding, CPC Certified
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Job Location: MUMBAI, India
In coding currently working on Medicus Outpatient coding & PAF gaps and Medicus ICD-10 code edits, UHC gap audits.
E&M coding (outpatient) – Now working on Medicus Coding Outpatient and coded charts with CPT, ICD & HCPC codes. Earlier Did Q.C of the coded charts; coding documentation adherence, CPT, ICD & HCPC codes & based on all these checking the E&M level
HCC coding - Checking if documentation meets for given HCC codes or not checking them with HCC coding list. If more than 12 diagnosis, then creating sibling claims & then dropping them for further clearance.
UHC gap audits – Checking RAF gaps on HBI portals to ensure the diagnosis are uploaded or not
Telemedicine – Worked on Telemedicine as per guidelines provided by the client for checking the E&M level, Modifier & ICD & if anything lacks adding the same to the claim & dropping them for further clearance reporting all these to the client on weekly basis.
RAF gaps - Adding HCC related potential diagnosis in claim to calculate the risk analysis & reporting the same to the client.
Also, sometimes helping the account team in resolving coding related denials or coding issues to get the claim paid or get it processed to next level.
To be considered for this position, applicants need to meet the following qualification criteria:
Graduates in life sciences with 5 year’s experience in Medical Coding
Experience in specialties such as Cardiology, Radiology, Pathology, Anesthesia, Emergency Room, Surgery, Neurology and others
Experience in HCC coding preferred
Exposure to CPT-4, ICD-9, ICD-10, and HCPCS coding
CCS/CPC/CPC-H/CIC/COC certification from AAPC /AHIMA would be a plus
Freshers with good knowledge in medical terminology, Human Anatomy and Physiology can apply
Current Coding certification with valid proof of certifications
Good knowledge of medical coding and billing systems, regulatory requirements, auditing concepts, and principles