Hi, I’m
KARUNYA N H
Senior Medical Coder - IPDRG
Trivandrum,KERALA
Summary
Knowledgeable medical office professional talented at correcting and resubmitting claims, preparing patient charts, and reviewing health records to identify proper diagnosis codes for billing. Offers background in reviewing, analyzing, and managing medical record information to obtain prior authorizations from insurance companies and ensure payment.
Overview
13
years of professional experience
7
years of post-secondary education
6
Languages
Work History
Coronis Ajuba Health ServicesChennai, TamilNadu
IP Medical Coder - Sr.
06.2021 - Current
Job overview
- Collaborated with healthcare providers to retrieve missing documentation for accurate code assignment.
- Increased revenue recovery through diligent follow-up on outstanding claims and appeals.
- Optimized billing procedures by working closely with the finance department, ensuring timely reimbursement for services rendered.
- Maintained ICD-10 proficiency, leading to more accurate code assignments and fewer claim rejections.
- Established strong relationships with insurance companies, facilitating smoother claim processing and payment negotiations.
- Ensured compliance with industry regulations by staying updated on current coding practices and guidelines.
- Enhanced team productivity by providing ongoing training and support to junior medical coders.
GEBBS HEALTHCAREMumbai, Maharashtra
IP Medical Coder
10.2020 - 04.2021
Job overview
- Roles and Responsibilities o Assign codes for INPATIENT (IPDRG) and HCC (QC)
- Responsible for translating healthcare providers’ diagnostic and procedural phrases into coded form by reviewing and analyzing health records to identify relevant diagnoses and procedures for distinct patient encounters
- Understood the health record’s content to find information to support or provide specificity for coding
- Knowledge of disease processes and procedural techniques to consistently apply the correct codes
- Gained in-depth knowledge of coding techniques and guidelines for medical coding
- Extremely knowledgeable about Medical Coding guidelines and coding techniques (ICD-10, CPT, PCS, DRG's)
- Proficient in inpatient hospital coding and evaluation management
- Strong knowledge of Anatomy & Physiology, Advanced Medical Terminology, Psychology, and Pharmacology
- Coding and quality assurance reviews performed on standard and comprehensive HCC projects as well as Inpatient projects
- Followed hospital coding guidelines and regulatory rules in governing corresponding coding decisions; reviewed and abstracted relevant clinical data/medical records to select and sequence the appropriate
- ICD-10-CM diagnosis Use of 3M and Encoder Pro
- Maintained at least 98% on both coding accuracy and completeness(HCC)
- Audit the chart processed, reviewed and share feedbacks to the individuals to keep the consistency going forward o Measure the accuracy according to the quality standards and guidelines.
Deccan I ServicesTrivandrum, Kerala
Medical Coder
12.2019 - 10.2020
Job overview
- Code medical records with ICD-10 and HCPCS Level II coding, processing charts while maintaining 98% accuracy, and achieving productivity goals
- Utilize ICD-10 books and implementation of ICD-10 diagnosis coding
- Handle a variety of medical claims in more than 10 clients including HCC in US health Depts
- Planning and maintaining compliance policies and keeping confidential information secure.
- Optimized workflow processes by developing efficient strategies for managing large volumes of medical records.
- Used classification manuals to gain additional knowledge of disease and diagnoses processes.
- Processed and tracked requests for medical records from external organizations.
Phykon Solutions, TVMTrivandrum, Kerala
Transaction Analyst
05.2018 - 11.2019
Job overview
- Ensuring data accuracy is Maintained in SAP
- Critical order management on daily calls, fax & emails from customers of Lion Diary and drinks
- Certified from Lion for order processing in SAP
- Report & log all customer issues into the Customer Relation Management database
- Day-to-day interaction with end customers & clients.
- Assisted in the development of new transaction processes to increase productivity and accuracy.
- Collaborated with team members to resolve complex transaction issues promptly and accurately.
- Safeguarded company assets, detecting fraudulent activities through careful monitoring of transaction patterns.
- Facilitated cross-departmental communication to ensure seamless execution of transactions and resolution of discrepancies.
Episourse India Pvt LtdChennai, TamilNadu
Medical Coder
04.2015 - 04.2017
Job overview
- Extensive knowledge of medical terminology across a broad range of medical practice areas.
- Strong understanding of ICD-10-CM and CPT requirements and procedures.
- Utilized knowledge of CPT and ICD-10-CM to properly translate performed services into numerical code for insurance company reimbursements.
- As a medical coder under the OPTUM project, able to meet the daily targets with accurate quality and worked in different Processes under the Optum Project.
- Sound knowledge of Datarap and SMA.
- Created and maintained up-to-date patient medical records to enable tracking history and preserve consistent information.
- Verified accuracy of patient information in medical records.
MIMSR Medical CollegeLatur, Maharashtra
Assistant Lecturer
02.2011 - 11.2014
Job overview
- Enhanced student comprehension by utilizing various teaching methods and incorporating multimedia resources.
- Collaborated with colleagues to design effective curriculum, resulting in better alignment of course objectives.
- Evaluated student performance fairly by implementing varied assessment techniques, ensuring accurate knowledge measurement.
- Assisted in the development of college policies and procedures, contributing to a more efficient academic environment.
- Participated in professional development workshops to continuously improve teaching skills and stay current with industry trends.
- Maintained accurate records of student attendance, participation, assignments, and grades while adhering to strict confidentiality standards.
- Developed easy and open rapport with students to encourage engagement and academic progress.
- Arranged syllabus, developed schedule, and determined reading list for varied courses simultaneously, giving students appropriate time to complete assignments and absorb information.
- Collaborated with faculty and staff to create meaningful learning experiences.
Accomplishments
- CRP Medical Coder – HCC
- Worked for the process along with clients and account managers to reduce pending chart
- Best Employee of the Year 2019 March, Phykon Solutions
- Worked with processes associated with Revenue cycle management apart from coding such as provider entry
Education
Pioneer College of NursingHyderabad
Bachelor of Science from Nursing
07.2006 - 12.2010
Soccorso HSSMala
Plus Two
06.2004 - 03.2006
St. Antony’s G.H.SThrissur
S.S.L.C - 10th
06.2003 - 03.2004
Skills
- CPT Code Modifiers
- Patient Data Compilation
- Patient Data Identification
- 3M Encoder
- Diagnostic Codes
- Medical Terminology
- Reviewing Patient Information
- Electronic Health Record Applications
- Protected Health Information
- Medical Claims Coding
- Medical Information Computerization
- Inpatient Coding
- Medical Records Security
- Coding Error Resolution
- ICD-10 (International Classification of Disease Systems)
Work Preference
Work Type
Full TimeLocation Preference
On-SiteRemoteImportant To Me
Work-life balanceCompany CulturePaid sick leaveHealthcare benefitsCareer advancementWork from home optionFlexible work hoursTeam Building / Company RetreatsAvailability
See my work availability
Not Available
Available
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Certification
- CPC - Certified Professional Coder
Timeline
IP Medical Coder - Sr.
Coronis Ajuba Health Services
06.2021 - Current
IP Medical Coder
GEBBS HEALTHCARE
10.2020 - 04.2021
Medical Coder
Deccan I Services
12.2019 - 10.2020
Transaction Analyst
Phykon Solutions, TVM
05.2018 - 11.2019
Medical Coder
Episourse India Pvt Ltd
04.2015 - 04.2017
Assistant Lecturer
MIMSR Medical College
02.2011 - 11.2014
Pioneer College of Nursing
Bachelor of Science from Nursing
07.2006 - 12.2010
Soccorso HSS
Plus Two
06.2004 - 03.2006
St. Antony’s G.H.S
S.S.L.C - 10th
06.2003 - 03.2004
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