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| Job Location | Chennai |
| Education | Not Mentioned |
| Salary | Not Disclosed |
| Industry | Recruitment Services |
| Functional Area | Back Office Operations |
| EmploymentType | Full-time |
Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding.Coding and clinical review for medical necessity of claims post adjudication that are in the pre - payment stage and have been identified as requiring such review;Documentation of clinical rationale supporting findings of review based on Client s coverage policies and procedures.Assistance in any later stages of the cases reviewed, including possible Technical Assessment and Medical Policy review and update.Review and validate all information pertaining to the claim including member, provider and plan information.Any clinical and coding support of client s Investigation process as otherwise requested.Know several different coding systems, including Level 1 HCPCS and Level 2 HCPCS.Investigate rejected claim to see why denial was issued.Investigate insurance fraud and report if found.Desired Profile AAPC s CPC or AHIMA s CCS certified Medical codersGood knowledge of ICD - 9 - CM / ICD - 10 guidelines or classification, ER, CPT codes, medical terminology and anatomy & physiology.Fresher / Experienced in Medical codingLaboratory coding experience is preferred,
Keyskills :
cpt icd programming radiology policyreview insurancefraud codingexperience medicalnecessity positionmanagement medicalterminology patienttreatment er cpc ccs fraud hcpcs codes claims medical cd10