This role is vital in ensuring the financial integrity of the company’s medical operations, optimizing revenue through accurate billing and coding practices, maintaining compliance with healthcare regulations, and promoting quality patient outcomes through effective case management. In addition, the role also includes facilitating communication between healthcare providers, patients, and payers, and supporting efficient utilization of healthcare services.

Eligibility / Qualification Required:

MBBS from an institute recognized by PMDC with at least 2 years of professional experience required in relevant field. OR MBA in Hospital Management from a recognized HEC university with at least 2 years of professional experience required in relevant field. Proven experience in medical billing, coding, and documentation within a healthcare setting. Strong understanding of healthcare regulations, billing codes, and compliance standards.

Job Description / Responsibilities:

• Oversee and manage medical billing and coding processes, ensuring accurate and timely submission of claims.
• Review medical records and documentation to ensure they meet billing requirements and compliance standards.
• Ensure all billing practices comply with relevant healthcare laws, regulations, and standards.
• Stay updated on changes in medical billing codes (ICD-10, CPT) and implement necessary adjustments.
• Conduct thorough reviews of patient medical records to ensure accuracy and completeness.
• Collaborate with healthcare providers to correct and update medical documentation as needed.
• Monitor and analyze billing and coding performance metrics to identify areas for improvement.
• Implement strategies to optimize the revenue cycle, reduce claim rejections and minimize reimbursements.
• Provide training and education to healthcare providers and billing staff on proper documentation and coding practices.
• Develop and deliver training programs to keep staff updated on billing regulations and best practices.
• Conduct regular audits of billing and coding practices to ensure accuracy and compliance.
• Implement quality assurance measures to prevent billing errors and reduce the risk of audits and penalties.
• The individual shall ensure compliance to the Enterprise Risk Management Framework enforced in the Company while performing job responsibilities in accordance with his assigned role.
• The individual shall ensure compliance to the Business Principles and Ethics Policy / Code of Conduct.
• Undertake any other assignment as instructed by immediate supervisor.

How to Apply:

Apply online by clicking the Apply Now button on the SSGC careers portal.