Indira Gopalsamy
Coimbatore
Summary
Dedicated and responsible healthcare professional with broad knowledge on healthcare revenue cycle from Coding, Billing and Claims processing. Highly familiar with medical terminologies, EHRs, ICD9/ICD-10 and CPT, HCPCS coding, and public/Federal and private/Commercial health insurance guidelines.
Possessing excellent management skills and having the ability to work with the minimum of supervision whilst leading a team. Having a proven ability to lead by example, improves best practices, and organizes time efficiently.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Quality Controller Medical Coding
Scribe EMR Systems Private Limited
Coimbatore
04.2022 - Current
- Assists in developing and maintaining policies and procedures for coding and coding guidelines.
- Performs coding quality reviews, provides feedback to coders, and educates coders.
- Project Stabilization by performing test audits (Assist the manager in client expansion and revenue improvement projects.)
- Developing Staff protocols to reduce risk & liability and denial prevention mindset in all parts of the revenue cycle.
- Maintain ongoing analysis by monitoring internal processes, evaluating benefits of implementing newer technologies, as well as updating the skill sets of employees to reduce denial rates and boost revenue.
Senior Medical Coder
Scribe EMR Systems Private Limited
Coimbatore
09.2021 - 03.2022
- Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures (CPT, ICD 10, HCPCS).
- Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
- Tutored new coders and several new providers for compliance by creating template and handbook on coding guidelines and updates.
- Interacted with physicians, other healthcare staff for any medical documentation related query or information.
Team Lead -Medical Coding
Nueved Business Services Pvt Ltd
Coimbatore
01.2017 - 09.2021
- Lead a team of medical-coding professionals, assigning workflow, and coaching to improve performance.
- Managed client SLAs (turn-around-time, quality), understand and finalized the scope with clients and onsite teams.
- Coordinated closely with medical providers to ensure compliance with policies of billing and documentation
- Ensured adherence to external and internal quality and security standards (HIPPA/HITECH/ISO)
- Maintained documentation to demonstrate adherence to compliance standards.
- Generated Monthly CBRs (Comparative Billing Report) and analysis of CBR for proper coding and billing of charts.
- Assisted in hiring and training new coders and provides input in performance evaluations.
Senior Medical Coder
Velan Info Services India Pvt Ltd
Coimbatore
03.2016 - 01.2017
- Worked as part of a team and help the team to achieve the goals in quality and productivity standards.
- Applied subject expertise in evaluating business operations and processes.
- Reviewed, Analyzed, and managed coding of diagnostic and treatment procedures contained in inpatient and outpatient medical records.
- Accurately followed coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies.
Team Leader - Medical Coding
XL Health Corporation India Pvt Ltd
Bangalore
03.2014 - 07.2015
- Lead a team of 20 medical coders and 4 senior medical coders.
- Designed and monitored daily/weekly/monthly metrics reports measuring the achievement of goals and assists in strategic planning.
- Executed Weekly Coder meetings and training sessions.
- Provided education to providers regarding Medicare coding guidelines, focusing on revenue enhancement opportunities.
Senior Medical Coder (HCC)
XL Health Corporation India Pvt Ltd
Bangalore
03.2012 - 03.2014
- Ascertained that coding efficiency and accuracy are improved by performing independent audits of physician and hospital records.
- Audited hospital, Retrospective (Office Visit) and House visit charts for HCC risk adjustment and HEDIS measures.
- Met production and quality goals as outlined by management.
Medical Coder (HCC)
XL Health Corporation India Pvt Ltd
Bangalore
10.2009 - 03.2012
- Reviewed medical records for their completeness and applied HCC coding guidelines and assigned appropriate diagnosis codes (ICD-9) with 96 percent accuracy.
- Conscientiously reviewed medical record information to identify appropriate coding based on CMS HCC categories.
Medical Coder
OMEGA HEALTH CARE PVT LTD
Bangalore
01.2009 - 10.2009
- Emergency ROOM coding (E/D)
- Assigned diagnostic and operative procedures according to ICD-9 CM and CPT classifications following the guidelines of CMS to Emergency room medical records.
Education
Master of Science - Immunology And Microbiology
The American College
Madurai07.2008
Bachelor of Science - Animal Science & Biotechnology
PSG College of Arts & Science
Coimbatore07.2006
Skills
ICD-9 CM, ICD-10 CM, CPT, HCPCS
ICD-10 AM, ACHI, ACS
Medicare & Medicaid guidelines, Commercial Payor requirements, Denial management Insurance eligibility check CCI/NCCI edits
Coding and billing software – chart viewer, Epic, Health fusion (NextGen), eCW(eClinicalWorks), Medent, IMS, Kareo, intergy, AdvancedMD
Lab management software – CGM LABDAQ, Labnexus
Coding tools – Encoder pro, AHA coding clinic, codify
Certification
CPC-H (current COC) WITH 83% - AAPC 2012
ICD-10 AM Certification from Transorze Solutions
Timeline
Quality Controller Medical Coding
Scribe EMR Systems Private Limited
04.2022 - Current
Senior Medical Coder
Scribe EMR Systems Private Limited
09.2021 - 03.2022
Team Lead -Medical Coding
Nueved Business Services Pvt Ltd
01.2017 - 09.2021
Senior Medical Coder
Velan Info Services India Pvt Ltd
03.2016 - 01.2017
Team Leader - Medical Coding
XL Health Corporation India Pvt Ltd
03.2014 - 07.2015
Senior Medical Coder (HCC)
XL Health Corporation India Pvt Ltd
03.2012 - 03.2014
Medical Coder (HCC)
XL Health Corporation India Pvt Ltd
10.2009 - 03.2012
Medical Coder
OMEGA HEALTH CARE PVT LTD
01.2009 - 10.2009
Master of Science - Immunology And Microbiology
The American College
Bachelor of Science - Animal Science & Biotechnology
PSG College of Arts & Science
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