Brenda Jane
Medical Coding
Chennai
Overview
13
13
years of professional experience
3
3
Languages
Work History
Senior Merchandiser
Revele India
11.2022 - Current
- Financial analysis -Cost management -FTE management and allocation -Operations management -Coding /Audit/ Training/ Compliance teams management -Collections goal achievement and team drive -Hiring and interview FTE and leadership roles -Multi location team management
- Managing Client Success team and Implementation team -Daily coordination with US teams operations -Daily coordination with reimbursement, Payment posting and other Billing teams
Manager/Acting head
QWAY
06.2019 - Current
- Day to day operations:
- Manage multispecialty projects and clients
- Manage service delivery criteria
- Take care of denial management
- Set up coding and qc team
- Set up coding training department
- Set up compliance standards for teams
- Select and maintain talent pool across team
- Conduct interviews
- Manage and monitor day to day operations internal and clients
- Manage client communication via mail and calls
- Give provider education on regular basis to increase reimbursement and reduce denials rate
- Other operational activities:
- Assisting in developing and implementing plans and goals for the department
- Collaborate with other departments for planned outcome
- Ensuring compliance with regulations and internal policies
- Undertake staffing responsibilities (hiring, training, evaluating etc.)
- Assist in budgeting and monitoring expenses
- Maintain scheduling of events and represent the company when needed Assist in budgeting and monitoring expenses Have training on GB tools.
LEAD, coding operations cum acting assistant manager
OMEGA Health-care
07.2017 - 12.2018
- Management services pvt
- Ltd as PROCESS, Multiple project exposure & handling
- Manage ED/ER, OP, IP, ASA, Radiology and surgery EM teams operations
- Manage service delivery criteria
- Manage 6 team leads across 2 locations
- Oversee 350 – 400 coders through team leads
- Manage work flows
- FTE management / retention management
- Plan attrition back fill project wise
- Manage FTE’s across locations & sites for production
- Location visit every 6 months for project monitoring purposes
- Manage team location wise (Chennai & Trichy)
- Manage employee elevation process
- Working for OMEGA health-care management services pvt
- Ltd as TEAM LEAD - service quality delivery and operations from march 2015 onwards till
VENDOR AUDIT MANAGEMENT
- 06.2017
- Manage team of vendor audit and report to client directly
- Handle client day in and day out on calls & mails with client and cse
- Maintain & calculate invoice & ebitda
- Handle positive escalations projections
- Handle monthly, quarterly and yearly projections
- Provide coding education feedback, error trends to client
- Handle appeal calls with client and coding vendors
- Handle dual coding & auditing (ICD-10-CM).
group coordinator/acting team leader – senior officer
DENIAL TEAM MANAGEMENT
04.2010 - 06.2014
- Handling around 20 members for ed/ surgery and multispecialty denials
- Prepare denial trend and submit to client
- Prepare TNI and provide improvement plans for coding team to increase quality and reduce denials
- Coordinate with mis for maintaining dashboard
- Coordinate with AR team and other RCM night shift teams by giving feedback on claims
- Help the RCM teams for timely claims submission
- Professional experience
- Ajuba solutions worked for Miramed Ajuba solutions in medical coding department (ER/ED –, Team / Floor Management
- Manage multiple team members from 20 – 40, have capacity to handle more as per requirement
- Experience as an approving authority
- Goal setting, coaching and feedback, performance management, team development
- Production planning monthly, weekly and daily queue management, movement of resource on need basis
- Conduct performance appraisals & monthly performance meetings (one-to-one) with teams
- Drive efficiency and productivity initiatives
- Positive escalation management (internal & client based) Reporting to manager
- MAJOR DUTIES:
- Hands of experience in transition process for professional and facility practices
- Experience in moving practices from transition phase to live coding
- Experience in selection and maintenance of talent pool for various processes e.g.: audit process, reports, etc
- Bring process improvements for quality management system on the floor
- Create motivation for teams to operate with quality on the floor
- REPORT
- Prepare & maintain production reports monthly, weekly and daily based
- Maintain audit reports internally and also for client purpose
- Maintain reports for minutes of meet for client calls, internal / external meetings & on the floor training
- Maintain other updates (practice related & ICD, CPT updates related)
- Maintain quality reports (coder based, team based & practice based)
- Maintain process orientation / work flow reports
- CLIENT INTERACTION
- Attend and assist in weekly conference calls and emails in a professional manner
- Preparation of practice related queries to forward to client
- Preparation of client weekly agendas in reply to client queries
- Document & discuss client interests & updates to teams across floor.
Skills
MS-office & toolsundefined
Accomplishments
- HOLDING CCS-P
- CERTIFICATION WITH 13+ YEARS EXP
- IN MULTI-SPECIALITY AND SUBSPECIALTIES
- INCLUDING -
- MEDICAL CODING (ED) PROFESSIONAL & FACILITY CODING / SURGERY & E M / ASA /OP / IP /
- RADIOLOGY
- AS AN RCM PROFESSIONAL I CARRY THE EXPERIENCE OF CLIENT
- TRANSITION
- MANAGEMENT, TRANSITIONED ACCOUNT SETTING., MAINTAINING QUALITY
- METRICS WITH TRAINING AND EDUCATION TO CLIENT AND TEAM, ALONG WITH
- COMPLIANCE BRIDGING MEASURES
- Experience in auditing er medical records (professional & facility)
- Audit for information security as isms agent
- Finding & highlighting error trends to bring up different audit styles resulting in maximum audit coverage / smart audit
- Experience in internal ISO audits
- SPECIAL AWARDS
- Have been awarded as best speaker by AJUBA in coding forum seminar
- Have been awarded as best outgoing student in B
- Sc in Nursing
- ACADEMIC QUALIFICATION
- Completed B.Sc in nursing from RGUHS
- Completed ccs-p (certified coding specialist-physician based).
Timeline
Senior Merchandiser
Revele India
11.2022 - Current
Manager/Acting head
QWAY
06.2019 - Current
LEAD, coding operations cum acting assistant manager
OMEGA Health-care
07.2017 - 12.2018
group coordinator/acting team leader – senior officer
DENIAL TEAM MANAGEMENT
04.2010 - 06.2014
VENDOR AUDIT MANAGEMENT
- 06.2017
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