- Evaluate inpatient claims to ensure they are accurate and compliant with healthcare regulations and payer guidelines.
- Assess the medical necessity of inpatient services provided and ensure that the documentation supports the claims.
- Work closely with clinical staff, billing teams, and insurance companies to resolve discrepancies and facilitate the claims process.
- Assist in developing and updating policies related to inpatient claims processing and compliance.
- Participate in audits and reviews to improve the accuracy of claims and reduce denials.
- Evaluate inpatient claims to ensure they are accurate and compliant with healthcare regulations and payer guidelines.
- Assess the medical necessity of inpatient services provided and ensure that the documentation supports the claims.
- Work closely with clinical staff, billing teams, and insurance companies to resolve discrepancies and facilitate the claims process.
- Assist in developing and updating policies related to inpatient claims processing and compliance.
- Provide training to clinical and administrative staff on documentation standards and coding requirements.
- Participate in audits and reviews to improve the accuracy of claims and reduce denials.
Physicians and pharmacists are welcome to apply3 years clinical experience not including internship yearExperience in health insurance companies or TPA companiesExperience in inpatient claim adjudication and processingExperience in coding (ICD10 AM, CPT and ACHI) is a plus