Medical Coding Senior Executive

Ascribe Healthcare Solutions

Roles and Responsibilities

• Ensure appropriate selection of principal diagnosis, qualifying secondary diagnosis, impacting procedures and others services which is relevant for submission and reimbursement.

• Effective physician query process prior to code assignment to obtain greatest possible diagnostic specificity and clinical documentation to accurately reflect the patient's condition.

• Consistently maintain quality and productivity standards and achieve the productivity target and quality targets

• Ensures to reduce rejections and get the claim paid at the initial submission of claims

• Perform other related duties incidental to the work described herein

• Identify documentation deficiencies and query physician for clarification and additional documentation prior to code assignment

• Adhere to the DHA Claims and Adjudication rules and coding guidelines

• Assign codes for pre-authorization process and effective response to payer queries coordinating with clinical team

• Ensures to reduce rejections and get the claim paid at the initial submission of claims.

• Perform other related duties incidental to the work described herein.

Education, Experience, and skills needed

• Basic knowledge in medical record review to abstract information required to support accurate coding

• Good skill in assigning accurate ICD-10-CM, CPT, DRG, HCPCS and other service codes for diagnosis and procedures performed in the OP/ER/IP setting.

• Excellent interpersonal skills while interacting with physicians, nurses and other staffs

• Knowledge on Diagnosis related grouping/p>

• Aware of current trends related to medical necessity, DRG and DHA and Adjudication rules and coding guidelines

• Proficiency in the use of PCs and MS Office suite/p>

• Excellent in communication skills.

• Good understanding of pre-authorization process and payer adjudication guidelines related to DHA or HAAD/p>