Found Description
- Work on complex infusion coding and reimbursement scenarios
- Build expertise in Medicare guidelines in a specialised setting
About Our Client
The client is a globally leading healthcare firm based in the US with a shared service operation in the Philippines.
Job Description
- Review diagnosis and medication coding for infusion services, particularly in complex or restricted payer scenarios
- Evaluate payer medical policies and regulatory guidelines to determine coverage and medical necessity
- Ensure alignment between clinical documentation and billing codes prior to service delivery
- Coordinate and validate completion of beneficiary notices and required modifiers within the system
- Apply advanced knowledge of Medicare guidelines and FDA label coverage to resolve coding exceptions
- Collaborate with intake, billing, and clinical teams to address discrepancies and improve docum...
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