:SUBMISSION TEAM

• Follow the mandatory SOP, checklist and relevant payer and coding guidelines.
• Checking demographic details of patient and make sure the front desk should select the proper regulatory policy (DHPO or RIAYATI)
• Proper documentations are entered in the Chart/ EMR/ Claim form by the doctors.
• Supporting details/ justification available in EMR of all investigation done.
• Checking all CPT codes entered are correct based on CPT guidelines.
• Checking excluded ICD and CPT based on Coding guidelines.
• Approved services and rendered services are match.
• Ensuring all requested investigations are done and invoiced.
• Check the claim with correct Receiver and Payer name before finalizing the bill.
• Check the claim with correct Patient Copay application.
• Ensure all claims are submitted to insurance company.
• Check the payer\'s name, rate plan and plan name selected properly.

Responsibilities:Submission Supervisor Checklist & Responsibilities

• Maintain Production sheet
• Allocate production claims details to submission team based on the claims generated data.
• Every month create production xl and document each staff wise daily production count.
• Sharing of daily production details and claims status to Sir JP.
• Maintain monthly Claims status
• Downloading 16 facilities claims generated count and update in the claim\'s status XL daily.
• Based on the data maintain finalized claims and pending claims details in the same xl.
• Maintain Correction claims details
• Monthly Create new folder in the sharing folder to maintain correction details for each centre wise.
• Share the correction details to respective clinic team.

Qualifications:

• A graduate of Bachelor\'s Degree in Allied Health Sciences or related areas
• At least two (2) years of coding experience with valid Certified Coding Associate(CCA) certification from American Health Information Management Association (AHIMA) or Certified Professional Coder (CPC) certification from American Academy of Professional Coders (AAPC).
• Must be computer Literate, MS Office.
• Excellent command of oral and written English.
• Performance Criteria:

Achievement of Core objectives in line with the expectations of the Management and stakeholders
Ability to work constructively and interact professionally with others
Ability to coordinate multiple task, adjust to changing priorities and work within deadlines.
Ability to attend to meetings outside of normal business hours

NMC Healthcare