The post holder will:
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.
Occupational Safety and Health Management Systems
Comply with reasonable OSH instructions, policies and safe working procedures
Use of appropriate personal protective equipment and safety systems.
Be familiar with emergency and evacuation procedures
Not willfully or recklessly endanger anyone’s health and safety
Assist with the preparation of risk assessments
Report OSH Hazards, incidents, Near misses and issues
Reduce, Reuse, Recycling of waste as much as possible
Attend all OSH Trainings, awareness programs and mock drills.
Participates in the OSHMS audits, inspections, ensuring standards are maintained
Infection Prevention and Control:
IPC is everyone’s responsibility. All staff are required to read and implement the NMC IPC Policy and Strategy in an effort to maintain the highest possible standards of cleanliness at all times, thus reducing the risk of infection in patients, staff and visitors.
The strictest hand hygiene, 5 moments of hand hygiene, bare below the elbows and environmental care, will be expected of all staff, including the post holder, at all times
Responsibilities:
The post holder will:
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.
Occupational Safety and Health Management Systems
Comply with reasonable OSH instructions, policies and safe working procedures
Use of appropriate personal protective equipment and safety systems.
Be familiar with emergency and evacuation procedures
Not willfully or recklessly endanger anyone’s health and safety
Assist with the preparation of risk assessments
Report OSH Hazards, incidents, Near misses and issues
Reduce, Reuse, Recycling of waste as much as possible
Attend all OSH Trainings, awareness programs and mock drills.
Participates in the OSHMS audits, inspections, ensuring standards are maintained
Infection Prevention and Control:
IPC is everyone’s responsibility. All staff are required to read and implement the NMC IPC Policy and Strategy in an effort to maintain the highest possible standards of cleanliness at all times, thus reducing the risk of infection in patients, staff and visitors.
The strictest hand hygiene, 5 moments of hand hygiene, bare below the elbows and environmental care, will be expected of all staff, including the post holder, at all times
Qualifications:
Degree, CPC