Aishwarya Ramji
Chennai
Summary
A well demonstrated 12 years experienced Leader in the field of medical coding handling various specialties like ED, E&M, SDS, Denial management and IP DRG. I hold a proven track record of working collaboratively with teams to achieve goals, increase revenue expectations and successfully sustaining the process through my innovative ideas in varied functions like Operations, Service line, Quality, Training and Coding products. Also, equipped with a diverse and promising skill-set that can be an asset to the organization thus resulting in optimal customer service.
Overview
12
12
years of professional experience
Work History
Deputy Manager of Operations
Savista Gobal Solutions Pvt. Ltd.
Chennai
10.2023 - Current
- Maintained high client SLA for SDS and IP DRG projects in the captive model.
- Created and maintained a strong team culture that promoted high levels of collaboration, employee satisfaction, and overall performance.
- Developed strong relationships with stakeholders to facilitate smooth communication and project completion.
- Evaluated and enhanced employee performance by providing regular feedback, coaching, and training opportunities.
- Used industry expertise, customer service skills, and analytical nature to resolve customer concerns and promote loyalty.
- Offered hands-on assistance to customers, assessing needs, and maintaining current knowledge of consumer preferences.
- Supervised day-to-day operations to meet performance, quality, and service expectations.
- Transitioned close to 3 new clients smoothly, without any hiccup.
- Worked in correct FTE utilization, thus optimizing the revenue.
- Established performance goals for employees and provided feedback on methods for reaching those milestones.
- Successfully managed the back-to-office program with minimal attrition.
RCM Product Lead
Whitespace Health (Omega healthcare pvt. ltd)
Chennai
08.2022 - 10.2023
- Responsible for creating the product requirements for denied claims
- Responsible for building rules based on the audit outcome for the denial and prebill coding product
- Created comprehensive documentation for each stage of product development, facilitating clear communication among all stakeholders involved in the process
- Optimized user experience by conducting usability testing and incorporating feedback into product designs
- Developed innovative solutions for complex technical issues, resulting in improved product performance
- Strategic planning to arrest revenue leakage, thus improving the financial performance
- ML or SQL-based data analysis to find out coding errors using CMS guideline-based rules developed
- Identifying the opportunities unnoticed by the competitors to incorporate those ROI-based value into the product
- Creation of BRD and process flow for the coding product
Team Lead
Omega Health care Pvt Ltd
Chennai
09.2019 - 08.2022
- Have been leading OP team of about 30 coders and 5 auditors involved in ED facility coding for one of the largest clients of Omega, performing routine operational activities such as SLA maintenance and quality maintenance
- Involved in the CAC transition, thus providing NLP opportunities to improve efficiency
- Maintaining process SOP and keeping records clean as per compliance policy
- Flashing Monthly Quality Dashboard, DPO report, IQ vs EQ comparison, sharing PIP recommendation
- Provided CAPA for the external errors received
- Responsible for maintaining shrinkage and attrition, thus meeting the target numbers on the roadmap
- Involved in client call deck preparation by providing operational and quality-related inputs
- Communicated directly with clients through emails and during client calls
- Also, preparing client call agenda and sharing minutes of meeting (MOM) was part of my listed activities
- Involved in the template creation and implementation of tools like OSCAR, RuBAT, and Codapt into our projects
- Have been leading OP team of about 30 coders and 5 auditors involved in ED facility coding for one of the largest clients of Omega, performing routine operational activities such as SLA maintenance and quality maintenance
- Involved in the CAC transition, thus providing NLP opportunities to improve the efficiency.
Process Coach
Omega Healthcare Pvt Ltd
Chennai
02.2016 - 06.2019
- Conducted Project specific OJT to the new joiners from Same day surgery and ED facility specialties
- Conducted refresher training to the TNI users thus improving their coding efficiency
- Conducted coding update training and measured the efficiency by conducting assessments in our in house platform i-learn
- Created Training Materials regularly based on team's lacuna
- Performed retro audits to capture top error contributors
- Queried physicians in case of ambiguity with the help of standard query forms issued by the client.
Coding Executive
Hinduja Global Solutions
Chennai
06.2014 - 12.2015
- Involved in captive business model for insurance specific coding, Humana
- Used to capture the coding errors that led to a denial
- Post physician coding from insurance perspective and educate physician
- Conducted several coding guideline related training across locations
- Have been involved in multi-specialty denial management.
Medical Coder Junior Officer
Ajuba Solutions Pvt Ltd
Chennai
09.2013 - 06.2014
- Performed Emergency department professional and facility coding
- Maintained SLA in terms of quality and production on a daily basis with 120 encounters coded per day.
Medical Records Coder Senior Representative
Dell International Pvt Ltd
Chennai
08.2012 - 09.2013
- Coded 100 E&M outpatient medical records with ICD-9, CPT-4 and HCPCS per day
- Handled wide variety of medical records for both new and established patients including Health and behavior assessment, Vaccination, Nutrition therapy, and Psychiatric therapeutic procedure, Pathology, Gynecology visit.
Education
CPC -
AAPC
10.2013
M.Sc Biotechnology -
Bharathidasan University
Tiruchirappalli04.2012
B.Sc Biotechnology -
Madras University
Chennai05.2010
Skills
- Performance Improvements
- Cost analysis and savings
- Task Delegation
- Operations Management
- Decision-making capabilities
- Project Management
- Problem-Solving
- MS Office
- Analytical Skills
- Adaptability and Flexibility
- Relationship Building
- Team building
- Self Motivation
- Excellent Communication
- Process Improvement
- Task Prioritization
- Analytical Thinking
- Customer Service
- Business Planning
- Positive Attitude
Languages
Tamil
First Language
English
Proficient (C2)
C2
Hindi
Upper Intermediate (B2)
B2
Specialties known
E&M
ED Profee
SDS
IP DRG
Multi specialty denial management
Software exposure
Citrix
Encoder pro
3M
Quanum
EPIC
CAC
Meditech
Merck's Manual
ICD 10 data
References
References available upon request.
Timeline
Deputy Manager of Operations
Savista Gobal Solutions Pvt. Ltd.
10.2023 - Current
RCM Product Lead
Whitespace Health (Omega healthcare pvt. ltd)
08.2022 - 10.2023
Team Lead
Omega Health care Pvt Ltd
09.2019 - 08.2022
Process Coach
Omega Healthcare Pvt Ltd
02.2016 - 06.2019
Coding Executive
Hinduja Global Solutions
06.2014 - 12.2015
Medical Coder Junior Officer
Ajuba Solutions Pvt Ltd
09.2013 - 06.2014
Medical Records Coder Senior Representative
Dell International Pvt Ltd
08.2012 - 09.2013
CPC -
AAPC
M.Sc Biotechnology -
Bharathidasan University
B.Sc Biotechnology -
Madras University
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