Encoder - 02

Summary Ensure the accurate coding entry in healthcare claims in order to obtain reimbursement from insurance companies and accurate invoices for cash patients.

Ensures that the patients are charged accurately and invoices are issued correctly according to the Hospital approved pricelist for all types of services provided to patients based on their financial status.

• Review patient file and records, and make sure all charges are charged accordingly as procedure performed.
• Charge all provided services in assigned location as provided by service providers in reference with financial categories and related codes.
• Obtain and review necessary claim data and services requirements.
• Ensure assigned codes meet required legal and insurance rules and that required signature and authorizations are placed prior to submission.
• Coordinate with Approval and Patient Accounts Section as well as healthcare professional and providers.

• Make sure services and doctor’s order are saved before sending the patient to the reception for payment.
• For Completion and submission of approval to insurance, make sure to communicate with healthcare professionals/provider for approval needs further details to avoid delayed in approvals.
• To ensure service charging and delivery for completion and submission of insurance related forms.
• Charges must be double checked compared with medical file entries and billing sheets.
• Ensure needed billing documents availability/completion/validation of accounts.
• To ensure that Encoders’ Flow Sheet for all discharge patient are properly filled up and submitted to the Office for review.
• Answering the inquiries of patients and visitors in a polite manner.
• Work is conducted in a professional manner and maintains patient confidentiality.
• Follows all department polices and procedures.
• Participates in on-going education program developed by the department, e.g. Department Policy and Procedures, Fire Safety, Risk Management, Environmental control.
• Performs additional tasks and duties as assigned by Supervisors and other authorities.