Divya Keshava
Bengaluru
Summary
❒ Good knowledge on medical claims.
❒ Having a strong attention to detail of reviewing the medical records and highly skilled in abstracting information and assigning codes to describe each documented analysis.
❒ Responsible for investigating and resolving coding denials that occur when claims are submitted to insurance companies or other third-party payers.
❒ Ensure health care providers meets specific documentation requirements that are essential in proper record keeping and claim reimbursement.
❒ Knowledge of medical terminology.
❒ Adds appropriate modifiers, codes narrative diagnoses, and verifies the accuracy of the diagnosis.
❒ Handling multi denials irrespective of CPT codes like POS, DX related, Age related, Same day 2 E/M visits, bundling, max units etc.
❒ Reviews and analyze health assessments to identify any unclear or incomplete clinical documentation and to determine appropriate coding.
❒ Analyses medical records and identifies documentation deficiencies.
❒ Denials on account of incorrect coding or other coding issues need a comprehensive process, including retrieving medical records, reviewing the medical codes ascribed.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Senior Executive Medical Coder
Sagility India Pvt Ltd
11.2019 - Current
Organization: Sagility India Private Limited (Formerly HGS) - Bengaluru, India 8/11/2019 ( over 4 years of experience)
Designation: Senior Executive medical coder.
Process - Physician claim insight for Humana Insurance
Specialty : Denial Management, Multi : Specialty
Duration: May 2022 to till now. (Internal movement under humana insurance as a non-coder to coder)
Designation: Senior Process consultant
Process - Financial recovery global post pay for Humana Insurance
Duration: Nov 2019 to April 2022.
Experienced and cheerful medical coder with over 4 years of hands-on experience in assessing provider documentation to ensure accurate code assignments. Well-versed in ICD-10 and CPT coding, Handling multi denials irrespective of CPT codes like POS, DX related, Age related, Same day 2 E/M visits, bundling, max units etc.. Ready to tackle new challenges in a remote-based environment, seeking a challenging position that encourages continuous learning and the exchange of new ideas, fostering both personal and professional growth in a stimulating sector.
Education
Bachelor of Commerce - Accounting And Taxation Group
Government First Grade Collage
Kolar, India06.2019
Skills
❖ Good communication skills
❖ Self-motivated and willingness to learn
❖ Ability to work under pressure in fast-paced environments
❖ Open to new and creative ideas
❖ Computer skills: MS-Word, Excel and outlook
Certification
- CPC - Certified Professional Coder - April 2022
Timeline
Senior Executive Medical Coder
Sagility India Pvt Ltd
11.2019 - Current
Bachelor of Commerce - Accounting And Taxation Group
Government First Grade Collage
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