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Job Description
Job summary:
- Managing all aspects of the content of medical patient records and patient information systems, including anything from information gathering and maintenance, data analysis and interpretation to designing, implementing, and maintaining health information technology systems.
- Provide training to clinical, clerical and professional staff regarding the contents, confidentiality, and security and coding of medical records.
- Combining knowledge of health care, health records and information management to provide services which meet the medical, legal, ethical, regulatory, and institutional requirements of the health care delivery system being served.
- Evaluate the medical necessity and consistency of diagnosis, procedure and descriptions stated on the claims according to medical coding rules and guidelines.
- Understand and work with mandated code sets like ICD, CPT, IRDRG codes, HCPCS and ACHI codes.
Tasks:
- System trainer.
- System Implementer.
- System Documentation.
- Supporting end users (hospital, PHC and clinic).
- Change Management.
- Utilization Review and Quality Assurance operations.
- Clinical Data Analysis and Extraction.
- Provides direction and planning for current and future healthcare technology and services offerings
- Engaged in the technical activities in the development of a Health Information System (HIS).
- Support and assisted the decision making process within the various health divisions
- Reviewing and creating medical edits.
- Mapping between different codes sets.
Job Requirements
Qualifications:
- Expertise in assigning accurate ICD-9-CM/ICD10CM, CPT, DRG, HCPCS and other service codes performed in the outpatient and inpatient setting.
- Expertise in ACHI code sets is an advantage.
- Applying advanced knowledge of medical terminology , anatomy and physiology, treatment modalities , diagnostic test, medications
- Adhere to the DHA and HAAD Claims and Adjudication rules and coding guidelines
- Expertise in Diagnosis Related Grouping/ Revenue cycle management.
- Expertise in Hospital Information system
Knowledge:
- Degree in any related field preferably healthcare background. CCA/CCS (AHIMA) or CPC (AAPC) certification is required.
- Minimum five years’ experience (2 years of the five years in medical coding in any setting i.e., hospital, clinic, payer).
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