Coder

•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.