Coder

Siloam Hospitals Group; Bekasi; On-site; IDR 60,000,000 - 90,000,000; Full time

Job summary

Siloam Hospitals Group seeks a BPJS operations professional to ensure INA-CBG coding accuracy and complete claim documentation for BPJS submission.

You will collect supporting documents from Front Office and Medical Records, coordinate with Internal Verifier, and organize files by SEP number before sending to Finance.

Requirements: Diploma (D3) in Nursing or Medical Records, 1 year BPJS operations experience, and familiarity with ICD/CPT/HCPCS; high attention to detail and problem solving.

Qualifications

• Minimum Diploma (D3) in Nursing or Medical Records.
• Likely 1 year of BPJS operations experience.
• Familiarity with ICD, CPT, and HCPCS coding systems.

Responsibilities

• Ensure accuracy of INA-CBG coding and completeness of documents for submitting claims.
• Collect claims supporting documents from Front Office and Medical Records and discuss with Internal Verifier for potential coding optimizations.
• Enter coding and hospital billing details per INA-CBG v5.2 and fill the coding form.
• Collaborate with Internal Verifier for revisions after IV review.
• Maintain claim documentation quality per BPJS Guide Book and organize by SEP number for Finance submission.
• Coordinate with Finance for documents on rejected claims and update BPJS SOP as required.
• Work with Casemix managers and Internal Verificators to prevent fraud.

Skills

Attention to detail

Problem solving

Code accuracy

Education

Diploma (D3) in Nursing or Medical Records

Tools

ICD coding

CPT coding

HCPCS coding

Job description

• Ensure the accuracy of the code entered into V-Claim, hospital billing details in the INA-CBG system and completeness of documents for submitting claims.
• Collect claims supporting documents from the Front Office (OPD) and from medical records (IPD) and discuss with the Internal Verifier if there are potential findings for coding optimization.
• Enter coding and hospital billing details in accordance with INA-CBG v5.2 and fill in the coding form.
• Collaborate with Internal Verifier for necessary revisions after review of IV.
• Ensure the completeness and quality of claim documentation in accordance with the 'BPJS Guide Book,' including organizing documents sequentially by SEP number and forwarding them to the Finance department for submission to BPJS.
• Collect documents from Finance for each rejected claim.
• Remain informed about the latest developments in BPJS coding and collaborate with the Finance department to integrate pertinent information into the BPJS Claim Standard Operating Procedure (SOP) as required.
• Collaborate with Casemix managers and Internal Verificators to prevent fraud.
• Have minimum Diploma (D3) Degree from Nursing or Medical Record
• Nursing or Medical Record
• Have minimum 1 year working experience in the field of BPJS operations.
• Familiarity with coding systems such as ICD, CPT, and HCPCS, is often required.
• High attention to detail to ensure accurate coding and minimize errors.
• Strong problem-solving abilities to address coding discrepancies and clarify documentation.

Qualifications

• Have minimum Diploma (D3) Degree from Nursing or Medical Record
• Have minimum 1 year working experience in the field of BPJS operations.
• Familiarity with coding systems such as ICD, CPT, and HCPCS, is often required.
• High attention to detail to ensure accurate coding and minimize errors.
• Strong problem-solving abilities to address coding discrepancies and clarify documentation.