Description
The GP will play a crucial role in ensuring accurate clinical documentation, coding, and pre-authorization processes to optimize the revenue cycle. The GP will collaborate with coders and medical staff to ensure all documentation is complete and in compliance with CHI and payers’ regulations.
Key Responsibilities:
- Review patient records to ensure documentation accuracy.
- Collaborate with medical coders to clarify diagnoses and treatments.
- Manage pre-authorization requests, ensuring compliance with payer requirements.
- Provide clinical expertise to the RCM and pre-authorization teams.
- Identify documentation gaps that impact coding and billing accuracy.
- Ensure adherence to healthcare regulations.
Skills
Requirements
- MBBS degree.
- Valid medical license SCFHS.
- Knowledge of medical coding (ICD-10, ACHI) and pre-authorization procedures.
- Experience in RCM or healthcare billing preferred.
- Strong communication skills and attention to detail.