Medical Coder

· Review and analyze patient records: Examine doctors' notes, medical documents, diagnostic reports, drug administration charts and other records ensuring that all diagnoses and procedures are properly documented.

· Assign codes: Use ICD 10 CM (International Classification of Diseases - 2021 guidelines) and CPT (Current Procedural Terminology - 2021 guidelines) and E&M (Evaluation and Management - 2018 guidelines) systems to assign standardized codes.

· DRG Assignment: Determine the appropriate DRG for each inpatient case based on the primary and secondary diagnoses, procedures, and other clinical data in the medical record.

· Compliance: Ensure coding practices are in full compliance with DOH regulations and Daman, ADNIC and other payer-specific guidelines. Follow all coding conventions and guidelines outlined by ICD-10, CPT, and DRG protocols.

· Medical Record Review: Review physician and clinical documentation to ensure completeness, accuracy, and clarity, and query healthcare providers when necessary to clarify or complete documentation.

· Coding Audits: Perform coding audits and reviews to identify discrepancies, errors, or opportunities for improvement in coding accuracy.

· Billing and Reimbursement Support: Collaborate with the billing department to ensure correct coding for billing purposes and support accurate claims submissions for reimbursement.

· Ensure accuracy: Verify that all codes are accurate and compliant with regulations.

1. Responsible for submitting claims with appropriate primary diagnosis, secondary diagnosis, primary procedures, secondary procedure codes, appropriate modifiers and DRG.

2. Responsible for maintaining accuracy of 95 % in internal audits.

· Maintain confidentiality: Uphold strict confidentiality in line with DOH guidelines and ensure patient information is kept confidential.

· Communicate with healthcare providers:

1. Clarify or obtain additional information as needed to justify the rejected claims or approvals.

2. For providing appropriate codes for approval, denial teams and to resolve coding-related issues and improve documentation practices.

· Continuing Education:

1. Stay updated with changes in coding guidelines, DRG system updates, and healthcare regulations through ongoing professional development, workshops, and

seminars.

2. Keep up-to-date with changes in coding standards and regulations.

3. Responsible for checking shafafiya DOH site for updated code sets, Mandatory tariff and circulars.

Job Types: Full-time, Permanent, Fresher

Pay: ₹15,000.00 - ₹18,000.00 per month

Application Question(s):

• Do you have Life science background

Education:

• Bachelor's (Required)

License/Certification:

• CPC (Required)