Job Description

Claims Processing Team: Submission o Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF / discharge summary for submission to various insurance companies on day-to-day basis. o Analysis of the UCF documentation issue from time to time and providing reports about areas of concern in coding and the claims. o Uploads OP E-claims. o Identifies commonly used ICD codes and relevant CPT codes and compile the list. o Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable). o Reports variations / irrelevance in the CPT codes used for services/procedures. o Assigns proper CPT/ HCPCS codes for newly added services / procedures. o Reports the audit findings about discrepancies in the claims daily. o Be available to the Consultants about clarification regarding the ICD/ CPT codes. o Coordinates with Insurance Doctors and Billing Supervisor/ Accountants for E claim Submission, Resubmission, Follow Up and Final Sign off. Claims Processing Team: Resubmission o Coder is required to review documentation by the physicians in the UCF / E - Discharge summary and look for discrepancies between the documentation and the coded, diagnosis and selected CPT codes. o Senior Coder required to overview the notes prepared for UCF / Discharge Summary have all the required information. In case any information is missing they need to contact the physician and get it filled. o Be available to the Consultants about any clarification regarding ICD/CPT codes. o Senior Coder is required to speak to clinicians about specialty specific rejections and reasons for the rejections and how to avoid such rejections.



Claims Processing Team: Submission o Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF / discharge summary for submission to various insurance companies on day-to-day basis. o Analysis of the UCF documentation issue from time to time and providing reports about areas of concern in coding and the claims. o Uploads OP E-claims. o Identifies commonly used ICD codes and relevant CPT codes and compile the list. o Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable). o Reports variations / irrelevance in the CPT codes used for services/procedures. o Assigns proper CPT/ HCPCS codes for newly added services / procedures. o Reports the audit findings about discrepancies in the claims daily. o Be available to the Consultants about clarification regarding the ICD/ CPT codes. o Coordinates with Insurance Doctors and Billing Supervisor/ Accountants for E claim Submission, Resubmission, Follow Up and Final Sign off. Claims Processing Team: Resubmission o Coder is required to review documentation by the physicians in the UCF / E - Discharge summary and look for discrepancies between the documentation and the coded, diagnosis and selected CPT codes. o Senior Coder required to overview the notes prepared for UCF / Discharge Summary have all the required information. In case any information is missing they need to contact the physician and get it filled. o Be available to the Consultants about any clarification regarding ICD/CPT codes. o Senior Coder is required to speak to clinicians about specialty specific rejections and reasons for the rejections and how to avoid such rejections.



High School, Diploma, Bachelor