Hemavathi Ravi
Chennai
Summary
Driven Team Leader with proven expertise in medical coding and healthcare technology at Optum Health and Technology. Skilled in ICD-10-CM, and HCPCS coding systems, consistently achieving 98% coding quality while ensuring compliance with healthcare regulations. Experienced in managing and training teams, streamlining processes, and enhancing efficiency through strong leadership and problem-solving abilities. Proficient in data visualization, business analysis, and effective communication, with a passion for continuous improvement and delivering high-quality client solutions. Recognized for attention to detail, adaptability, and a track record of contributing to team success through innovation and dedication.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Team Leader - Medical Coding
Optum Health and Technology
Chennai
07.2016 - Current
- Contributed to natural language processing projects by analyzing data and developing algorithms.
- Acquired in-depth expertise in ICD-10-CM coding, CPT, evaluation and management, and HCPCS codes.
- Attained minimum of 98% coding quality based on client specific guidelines.
- Performed internal audits to review and correct trainee codes prior to client submission, ensuring adherence to quality standards.
- Abstracted all medical data to assign appropriate codes for hospital inpatient and outpatient records.
- Reviewed medical records to accurately assign diagnoses and procedure codes using ICD-10-CM and CPT conventions.
- Being a global technology-enabled company, OHT provides simple, quality, and cost-effective solutions tailored to the needs of our clients.
Education
B.Tech - biotechnology
Arunai Engineering college
Tiruvannamalai05-2016
Higher secondary education - SSLC
E S Matric Hr Sec School
Villupuram05-2012
Skills
- ICD-10-CM coding
- Expert medical coding
- Medical coding and abstracting
- Claims processing and management
- Healthcare analytics
- Medical terminology mastery
- Coding standards compliance
- Quality assurance and review
- Coding error resolution
- Clinical documentation improvement
- Patient data identification
- HIPAA compliance
- Data analysis and visualization
- Power BI proficiency
- Excel and macros proficiency
- Matplotlib for data visualization
- MongoDB database management
- Process optimization strategies
- Records management systems
- Data verification techniques
- Project management skills
- Team leadership and coordination
- Time management abilities
- Problem-solving expertise
Certification
• CRC (Certified Risk Adjustment Coder), AAPC, 04/01/20, Present
• Certified Professional Achievement in Master Data Science, GUVI-IIT MADRAS, 07/01/22, 12/01/22
• Certified Professional Achievement in Master Data Science, GUVI-IIT MADRAS, 07/01/22, 12/01/22
Accomplishments
Quality Award (Quarterly), Epi-source India Pvt. Ltd., 10/01/2019, 12/01/2019.
Projects
- HCC & HHS Coding Projects (Team Lead Role): Directed end-to-end project delivery for Hierarchical Condition Category (HCC) and Health and Human Services (HHS) coding initiatives. Ensured timely completion with exceptional quality standards, managed and trained coding teams, and streamlined processes to improve efficiency and compliance.
- NLP ICD-10-CM Tool: Developed a Python-based application to explore ICD-10-CM codes. Implemented features to check code existence, trace hierarchical relationships, and retrieve associated descriptions, enhancing usability for medical coding analysis.
- Healthcare Resource Utilization Dashboard: Designed interactive dashboards in Power BI to visualize hospital resource usage. Enabled better decision-making for capacity planning and operational efficiency.
- Claims Fraud Detection: Built machine learning models to detect anomalies in healthcare claims data. Improved fraud detection accuracy and reduced financial risks by identifying suspicious patterns.
Languages
- Tamil
- English, Professional Working Proficiency
- Tamil, Native or Bilingual Proficiency
Timeline
Team Leader - Medical Coding
Optum Health and Technology
07.2016 - Current
B.Tech - biotechnology
Arunai Engineering college
Higher secondary education - SSLC
E S Matric Hr Sec School