Description

Job Description

SUBMISSION TEAM

• Follow the mandatory SOP, checklist and relevant payer and coding guidelines. 
• Checking demographic details of patient and make sure the front desk should select the proper regulatory policy (DHPO or RIAYATI)
• Proper documentations are entered in the Chart/ EMR/ Claim form by the doctors.
• Supporting details/ justification available in EMR of all investigation done.
• Checking all CPT codes entered are correct based on CPT guidelines.
• Checking excluded ICD and CPT based on Coding guidelines.
• Approved services and rendered services are match.
• Ensuring all requested investigations are done and invoiced.
• Check the claim with correct Receiver and Payer name before finalizing the bill.
• Check the claim with correct Patient Copay application.
• Ensure all claims are submitted to insurance company.
• Check the payer’s name, rate plan and plan name selected properly. 

Responsibilities

SUBMISSION TEAM

• Follow the mandatory SOP, checklist and relevant payer and coding guidelines. 
• Checking demographic details of patient and make sure the front desk should select the proper regulatory policy (DHPO or RIAYATI)
• Proper documentations are entered in the Chart/ EMR/ Claim form by the doctors.
• Supporting details/ justification available in EMR of all investigation done.
• Checking all CPT codes entered are correct based on CPT guidelines.
• Checking excluded ICD and CPT based on Coding guidelines.
• Approved services and rendered services are match.
• Ensuring all requested investigations are done and invoiced.
• Check the claim with correct Receiver and Payer name before finalizing the bill.
• Check the claim with correct Patient Copay application.
• Ensure all claims are submitted to insurance company.
• Check the payer’s name, rate plan and plan name selected properly. 

Qualifications

Bachelor with CPC Coding/AAPC