RCM Executive NMC Specialty Hospital Dubai
Full time @NMC Healthcare posted 3 months ago in Healthcare Shortlist Email JobJob Detail
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Job ID 13402
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Career Level Intermediate
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Experience 2 Years
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Gender Male Female
Job Description
NMC Healthcare is currently seeking to hire a candidate for the job role of a RCM Executive in NMC Specialty Hospital, Dubai, UAE. This is an Intermediate level full time role. For this position salary ranges from 7000-15000 AED, which may be slightly negotiable during the interview process.
Responsibilities of RCM Executive
- Claims Processing Team: Submission.
- Verifies the ICD1O CM codes and relevant CPT/ HCPCS codes on the UCF / discharge summary for submission to various insurance companies on day-to-day basis.
- Analysis of the UCF documentation issue from time to time and providing reports about areas of concern in coding and the claims.
- Uploads OP E-claims.
- Identifies commonly used ICD codes and relevant CPT codes and compile the list.
- Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable).
- Reports variations / irrelevance in the CPT codes used for services/procedures.
- Assigns proper CPT/ HCPCS codes for newly added services / procedures.
- Reports the audit findings about discrepancies in the claims daily.
- Be available to the Consultants about clarification regarding the ICD/ CPT codes.
- Coordinates with Insurance Doctors and Billing Supervisor/ Accountants for E claim Submission, Resubmission, Follow Up and Final Sign off. Claims Processing Team: Resubmission.
- Coder is required to review documentation by the physicians in the UCF / E – Discharge summary and look for discrepancies between the documentation and the coded, diagnosis and selected CPT codes.
- Senior Coder required to overview the notes prepared for UCF / Discharge Summary have all the required information. In case any information is missing they need to contact the physician and get it filled.
- Be available to the Consultants about any clarification regarding ICD/CPT codes.
- Senior Coder is required to speak to clinicians about specialty specific rejections and reasons for the rejections and how to avoid such rejections. Page 3 of 6 Controlled Document ADM-HRF-24-R01.
- Verifies the ICD10 CM codes and relevant CPT/HCPCS codes on the claims for submission to various insurance companies on day-to-day basis.
- Provides Reports/feedback about proper implementation of ICD/ CP coding.
What you will do more
- Provides training material and support to the cashiers/claims processors / nurses with regards to ICD/CPT and other relevant medical coding requirements.
- Identifies the ICD codes (Diagnosis under Exclusion) and CPT codes (not billable).
- Uploads of e-claims to the DHPO and/or any other portal necessary for claiming payments of direct billing claims.
- Coordinates with Insurance Companies medical teams for clarifications and other day to day issues.
- Coordinates with Billing Supervisor / Accountants for e·claim submission, Resubmission, Follow Up, Reconciliation and Final Sign off.
- Enters the codes in the software application.
- Adheres to the company’s policies and procedures.
- Responsible for lP E-claim Submission/IP & OP Resubmission/Reconciliation.
Requirements for Role of RCM Executive
- High School, Diploma, Bachelor healthcare administration, business administration, finance, or a related field.
- 2+ years of experience in healthcare finance, billing, or revenue cycle management.
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