RCM Executive - UAEN

Job Description

• Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF / discharge summary for submission to various insurance companies on a day-to-day basis.
• Analysis of the UCF documentation issue from time to time and providing reports about areas of concern in coding and the claims.
• Uploads OP E-claims
• Identifies commonly used ICD codes and relevant CPT codes and compiles the list.
• Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable). 
• Reports variations/irrelevance in the CPT codes used for services/procedures.
• Assign proper CPT/ HCPCS codes for newly added services/procedures.
• Reports the audit findings about discrepancies in the claims daily.
• Be available to the Consultants for clarification regarding the ICD/ CPT codes. 
• Coordinates with Insurance Doctors and Billing supervisors/ Accountants for E-claim Submission, Resubmission, Follow Up, and Final Sign-off. Claims Processing Team: Resubmission
• The 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. 
• 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.
• Be available to the Consultants about any clarification regarding ICD/CPT codes. 
• Senior Coder is required to speak to clinicians about specialty specific rejections and reasons for the rejections and how to avoid such rejections