Dolly Gupta

Identification, analysis, and appeal of denied insurance claims, focusing on correcting coding errors to maximize reimbursement.

Manage workflows to prevent future denials by auditing clinical documentation.

Training staff on payer guidelines, and collaborating with billing to ensure timely, compliant claim resubmissions.

• Managed and motivated employees to be productive and engaged in work.

• Overseeing and managing all aspects of quality assurance and quality control within an organization.
• Developing, implementing, and maintaining quality management systems, policies, and procedures.
• Monitoring performance and collecting feedback from employees and clients.

• On-boarding & Batch allocation of new hire
• Manage and supervise the coding team
• Providing guidance, support, and training as needed.
• Monitor productivity& quality

• Update the guideline whenever CPT and ICD get updated.
• Create training content and preparing PPT. Providing classroom training for CPC & CCS certification.
• Provide client specific training.
• Responsible for focused training based on audit analysis.

• Practice Worked: - Risk Adjustment Coding, Evaluation and Management, Provider Denial Management
• Assignment of accurate code and abstracting clinical information from medical records.
• Maintaining accuracy of more than 98%
• Performing QA on Level 1 coders work

• Practice Worked: - Risk Adjustment Coding, Denial Management
• Assignment of accurate code and abstracting clinical information from medical records.
• Maintaining accuracy of more than 98%
• Performing QA on Level 1 coders work

• Practice Worked: - Risk Adjustment Coding & IP DRG, Assignment of accurate code and abstracting clinical information from medical records.
• Maintaining accuracy of more than 98%
• Providing feedback and train them in the area of improvements.

• Training the batch of 25 aspirants in CPT/ICD9 coding modules; with success rate of 15-CPC qualified.
• Taught human anatomy and physiology in detail for better understanding of medical terminologies.
• Meeting the training requirements and focused on earning environment.
• Taking feedback from the students and improving the training processes.

• Practice Worked-Evaluation and Management (Admission to hospital Code), ASC Surgery.
• Assignment of accurate code and abstracting clinical information from medical records.
• Maintaining accuracy of more than 98%
• Performing QA on Level 1 coders work
• Providing feedback and train them in the area of improvements.

• Worked for diagnostic radiology and E/M (outpatient) coder
• Worked as IVR Coder.
• Training and Buddy ups of new trainees.
• Meeting SLAs and reporting to the manager.
• Preparing Training modules and preparing MOMs
• Mentoring of new joiners in the team
• Performed quality checks as well