Clinical Coding Expert

3 days ago


Dublin, Dublin City, Ireland Irish Life Group Services Limited Full time

Irish Life Group Services Limited is seeking a highly skilled Clinical Coding Expert to join our Claims Operations function.

Job Responsibilities

This role involves actively involving in the ICD (International Classification of Diseases) of health claims, ensuring technical accuracy of coding completed in line with ICD-10 and responsible for timely quality data.

The key responsibilities of this role include:

  • Reviewing medical claims and assigning ICD-10 codes
  • Ensuring technical accuracy of coding completed in line with ICD-10
  • Completing governance audits for all processed Hospital and Member Claims
  • Liaising with relevant TPAs for overseas cases
  • Acting as the first line of defence and identifying any potential areas of inappropriate billing, fraud and abuse of the hospital and member claims process
Requirements

The successful candidate will hold an APA qualification (or higher) and will have 1-3 years' experience in health insurance claims assessment and ICD-10-AM clinical coding.

A prior experience in health insurance with a good knowledge of claims processes, assessment rules, policy terms and conditions is preferred.

About Us

Irish Life is one of Ireland's leading financial services groups with over 1.5 million customers. For over 80 years, we've been helping people to look after their life insurance, pension and investment needs, and more recently their health insurance.



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