Medical Coder

Submission of claims to Insurance Companies, preparation of claims reports monthly within the stipulated time and responsible for obtaining, interpreting, identify the denied claims, analyze and resubmitting the claims to Insurance companies.

RESUBMISSION TEAM

• Analyzing the rejections
• Clarifying the Rejection queries to the Insurance Company
• Doing Resubmission production for assigned facility with quality.
• Sharing rejection feedback to the Submission team
• Sharing rejection feedback to the Approval team
• Sharing rejection feedback to the reception team.
• Facilities doubt clearing (Coding, insurance Queries)
• Monthly team meeting in sharing the ideas regarding insurance rejection.
• Sharing rejection updates to medical auditor to share with respective doctor.
• Supporting submission team for their queries
• Providing justification for RECONCILIATION claims.

Resubmission supervisor roles and responsibilities: 

• Preparing date-wise production log for the team. (Pharmacy /Clinic)
• Facilities doubt clearing (Coding, insurance Queries).
• Sharing rejection feedback to the Submission team.
•  Sharing rejection feedback to the Approval team.
•  Sharing rejection feedback to the reception/registration team.
•  Sharing doctor monthly rejection reports to accounts.
•  Sharing recon sheet to all team members.
•  Giving feedback to the resubmission team.
• Giving Induction to New joiners.
• Clarifying the queries to the Insurance Company.
• Auditing the resubmission files and sharing the feedback with the team.
• Monthly team meeting with resubmission team sharing the ideas.
• Analyzing the rejections.
•  Sharing rejection updates to medical auditor to share with respective doctors.
• Doing Resubmission production for assigned facility.
• Supporting submission team for their queries
•  Maintain the production log in the E-claim link DHPO from team. • Clearing the team’s queries regarding rejections.