Dr Anjana Pahuja

• Led a team of 90+ Medical Coders specialized in risk adjustment coding (Hierarchical Condition Category Coders) and HEDIS, 3 Assistant Managers and 6 Subject Matter Experts, ensuring compliance with ICD-10, CPT and HCPCS standards.
• Recruited, interviewed and hired employees and implemented mentoring program
• Identified areas for improvement within the department, implementing strategic initiatives to address gaps in performance or resources.
• Created and maintained a strong team culture that promoted high levels of collaboration, employee satisfaction, and overall performance by driving engagement activities.
• Provided data driven insights to optimize revenue cycle management and driven cost savings.

• Led team of 40 Appeals and Recons clinical reviewers , gained exposure to work on different line of businesses from different locations and demonstrated capabilities such as resolving conflicts, negotiation, resilience, critical thinking, and interpersonal skills.

• Played vital role in end-to-end transition and migration of various commercial processes , fostered positive relationships with stakeholders to maximize satisfaction, retention, and experience.

• Assisted in recruiting, interviewing, hiring, and onboarding of new employees to maintain adequate staffing levels and capacity planning.

• Championed professional development and high performance by overseeing employee recognition program.

• Trained and mentored high-performing team through regular performance reviews, individual feedback, and professional coaching.

• Led team of 20 Non-Clinical investigators to understand the end-to-end workflow
• Worked on Inventory management, handling RPAs and capacity planning
• Improved management skills by participating in rigorous training programs and workshops.
• Developed problem-solving abilities through hands-on experience with real-life business scenarios.
• Established open and professional relationships with team members which facilitated communication, quickly resolving issues, and conflicts.
• Established team priorities, maintained schedules and monitored performance.

• Excelled in medical coding and abstracting patient encounters, including diagnostic and procedural information. Process involved clinical validation and investigation of Pre-Pay claims using medical expertise, knowledge of CPT/ diagnosis codes, in order to ensure integrity of Fraud, Waste, Abuse, and Error (FWAE) guidelines.
• Adhered to HIPPA, CMS (Centers for Medicare & Medicaid services), and payer guidelines for coding and billing.

• Experienced working in multi-vendor and community setting environment, good conflict management, and prioritizing skills.
• Enabled sports-specific rehabilitation to enhance mobility and wellbeing for range of patients.
• Identified specific interventions from multidisciplinary team to deliver best plan of care.
• Promoted continuous business improvement based on knowledge gained from client implementation, previous experiences, and ideas.

• Worked as QC and QA to ensure client targets are met and conducted sessions to bridge the knowledge gap of team.
• Enhanced clinical decision-making through comprehensive research and analysis of complex cases.
• Bolstered compliance with HIPAA regulations by maintaining strict confidentiality standards when handling sensitive patient information.

• Implemented strategies to strengthen muscles, improve bodily functions, and restore balance and coordination.
• Followed safety standards and optimum techniques with use of exercise equipment and aides, protecting patients from undue risks.
• Monitored patients during treatments, assessing progress and mobility to determine success or failure of treatment plans

• Facilitated patient flow ensuring assessment, rehabilitation, and discharge planning needs.
• Improved patients' range of motion and assisted in muscle reeducation and strengthening through techniques including manual and electrotherapy.
• Educated families and patients on proper body mechanics and selfcare practices to improve long-term outcomes.
• Reduced recovery time for injured athletes by developing sportspecific training programs and monitoring progress closely.