Medical Coder OP/IP

Canadian Specialist Hospital is seeking a Medical Coder with Inpatient (IP) and Outpatient (OP) coding experience, preferably within a hospital setting. The ideal candidate will play a critical role in ensuring accurate documentation, coding, and billing compliance to optimize the hospital’s revenue cycle.

Interested candidates may apply by sending their CV to [email protected].

Key Responsibilities:

• Ensure documentation and billing compatibility according to the rule engine.
• Manage electronic claim submissions and monitor E-Prescriptions for accuracy and timeliness.
• Report daily activities to the designated authority and handle queries from other departments regarding medical coding.
• Coordinate with insurance companies to resolve E-Claim issues and denials.
  Enter missing codes to ensure revenue cycle completeness.
• Update the Hospital Management System (HMS) with relevant codes and information.
• Liaise with approval, billing, and reconciliation teams to complete the claims process.
• Support and strategize with the approvals team for efficient code-based approvals.
• Monitor the rule engine for predictable claim rejections and take corrective actions.
• Report service level auditing findings and ensure compliance with insurance protocols.
• Implement strategies to enhance revenue flow and minimize denials.
• Supervise DRG activities as per the guidance of the Head of RCM.

Qualifications & Requirements:

• Bachelor’s degree in a medical-related field.
• Certified Coder (CPC, CCS, or equivalent).
• 2+ years of experience in medical coding, preferably in a hospital.
• Strong knowledge of ICD-10, CPT, HCPCS, DRG, and insurance regulations.
• Proficiency in Microsoft Office Suite (Excel, Word, Outlook, PowerPoint).
• Excellent verbal and written communication skills.
• Ability to work collaboratively with various departments and external stakeholders.