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Client’s specific guidelines/ coding and claims processing standards 5S and 3Rs Screen claims Claims are checked for authorization, eligibility based on provider and/or subscriber contract with the payer Completeness of claims documentation are checked in accordance with payer requirements Lacking data based on the initial screening result are requested from medical provider Medical Terminologies Medical Documentation Medical claim process Healthcare Laws and Ethics Essential of healthcare insurance Medical Coding Systems International Classification of Diseases Current Procedural Terminology Healthcare Common Procedure Coding System Client’s specific guidelines/ coding and claims processing standards Analytical skills Reading and comprehension skills Researching skills mathematical skills Communication skills Computer skills Process claims/billing Encode patient, provider and/or billing information Determine reimbursable procedures and/or services based on existing insurance contract or provider contract or any existing reimbursement guidelines Billing information is verified for completeness of data based on the required fields. Determine billing address and facility based on insurance contract Medical Terminologies Medical Documentation Medical claim process Healthcare Laws and Ethics Essential of healthcare insurance Medical Coding Systems include but not limited to: Diagnosis Code Set Procedure Code Set Supplies Code set Client’s specific guidelines/ coding and claims processing standards Analytical skills Reading and comprehension skills Researching skills Basic mathematical skills Communication skills Computer skills