Job description
Perform a variety of activities involving the coding of medical records by assigning accurate diagnosis and CPT codes Perform Coding for Outpatient and/or Inpatient records with a minimum of 98.5% accuracy and as per turnaround time requirements
Exceed the productivity standards for Medical Coding - as per the productivity norms for inpatient and/or specialty-specific outpatient coding standards Maintain a high degree of professional and ethical standards
Focus on continuous improvement by working on projects that enable customers to arrest revenue leakage while being in compliance with the standards Focus on updating coding skills, knowledge, and accuracy by participating in coding team meetings and educational conferences
Duties Responsibilities
- Service Delivery
- Manage client SLAs (turn-around-time, quality)
- Production planning monthly, weekly and daily queue management, movement of resource on need basis
- Project management Resource planning as per project scope, risk management, escalation management. Achieve client and organization objectives for a given project
- Quality Management Effective monitoring of quality performance, root causes and resolutions to the quality challenges of the team
- Team Management
- Goal setting, coaching and feedback, performance management, team development
- Provide SME and problem solving support for day to day issues
- Identify training gaps and plan trainings
- Process improvement
- Drive efficiency and productivity initiatives
- Improve client and employee experience by continuous improvements
- Effective utilization of coders via cross training across different project scopes
- Ensure adherence to external and internal quality and security standards (HIPPA/HITECH/ISO)
- Maintain documentation to demonstrate adherence to compliance standards
- Review Medicare Local Coverage Determination (LCDs) and Medicare bulletin updates and Medicare NCCI updates
- Review coding denials from payers and requests for notes for claim review and processing
Desired Candidate Profile
- Worked at least 1 year as Group coordinator/SME.
- Current team leader experience of 1 year or less than a year
- Medical Coding experience of 4-5 years preferred
- Understanding of US Healthcare industry, including but not limited to HIPAA/HITECH
- Experience in E/M- IP and OP coding specialty is preferred
- Strong knowledge in Anatomy & Physiology
- Risk Adjustment coding experience is an added advantage
- Certification in CPC or CCS is Mandatory
Education and Skills
- B Pharmacy, M Pharmacy, Bsc, Msc &Btech Biotechnology, Bsc & Msc Microbiology, Biochemistry, B. Sc (Nutrition & Dietitian), BE Biomedical, BPT, Nursing, Zoology & Any Life Science Graduate
- Ability to work on software applications systems and a willingness to learn
- Good computer skills with typing skill of 30 WPM with 95% accuracy.
- Good Knowledge in clinical indicators. Good knowledge in Insurance Guidelines.
