maecatherinemangaring
About Candidate
Assigning Correct Codes: Apply appropriate CPT (Current Procedural Terminology) codes, ICD-10 codes, and HCPCS codes for medical procedures and diagnoses. For dental procedures, use ADA CDT (Current Dental Terminology) codes.
Coding Procedures and Diagnoses: Ensure that all healthcare services, treatments, and procedures are correctly coded, including surgeries, laboratory tests, consultations, and routine check-ups for medical coding, as well as fillings, cleanings, and root canals for dental coding.
Review and Interpretation: Review patient charts, treatment notes, and provider documentation to assign the most accurate and up-to-date codes.
Claims Preparation: Prepare claims for submission to insurance companies (including private insurers, Medicaid, and Medicare) for reimbursement. This involves entering coded information into billing systems and verifying that all data is correct.
Reimbursement Follow-Up: Follow up on unpaid, denied, or rejected claims by liaising with insurance providers and ensuring issues are resolved, often by revising and resubmitting claims as necessary.
Patient Accounts: Ensure that patients are correctly billed for their services based on the codes assigned and that any discrepancies between insurance claims and patient responsibility are addressed promptly.
Location
Education
A degree program that focuses on the study of human behavior, mental processes, and emotions. This program typically blends scientific research with an understanding of human experiences. It provides students with a comprehensive foundation in psychology, preparing them for careers in various fields or further graduate study in psychology or related disciplines.
Work & Experience
• Assist the physician in initial assessment and patient scoring grid for preapproval request • Review claims submission as per Insurance Company’s policy to ensure timely reimbursement. • Verify and ensure that insurance information and authorizations provided are current • Verify and checking Eligibility through Daman Portal
Submit medical claims to insurance companies (e.g., PPO, HMO, Medicare, Medicaid) on behalf of healthcare providers. Ensure that all services provided to patients are accurately billed according to insurance codes (CPT, ICD-10, HCPCS). Use electronic systems or paper forms to submit claims to insurance carriers and government programs. Check the accuracy of claim details before submission to avoid claim denials or rejections. Verify patient insurance eligibility and benefits before providing services, ensuring that the correct information is available for billing. Collect necessary details from insurance companies regarding what services are covered and the patient’s responsibility for co-pays or deductibles. Prepare and send out patient invoices for out-of-pocket expenses such as co-pays, deductibles, and balances not covered by insurance. Communicate with patients regarding their bills, explaining any charges and assisting them in understanding their insurance benefits. Handle payment collections from patients and ensure that payments are properly recorded.
• Assist the physician in initial assessment and patient scoring grid for preapproval request • Submit pre-authorization request online following respective insurance company’s policy. • Submit pre-authorization request online following respective insurance company’s policy. • Verify and ensure that insurance information and authorizations provided are current • Verify and checking Eligibility through Daman Portal • Perform the other task to secure client payment.Preparing the Invoice and collect deductible, co-payments as per insurance policies • Assist other admin staff in computer related works • Maintain accurate billing and collection on a daily basis and submit it to finance head office.
•Greet and receives patient coming for check-up to meet doctors •Collect all necessary information of the patients and enter in the company provided system CONCEPT. Clinical documentation claims pre-submission audit on billing guidelines. • Coordinate with Clinical Nurse in creating module for clinical documentation improvement to raise standards of quality and compliance. • Assign CPT (procedure codes) and ICD (diagnosis codes) for billing services. • Submit pre-authorization request online following respective insurance company’s policy. • Assist the physician in initial assessment and patient scoring grid for preapproval request • Collect all necessary information of the patients and enter in the company provided system CONCEPT.. • Checking medical services via CONCEPT system and Electronic Medical Records.
