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.
Work History
IP Medical Coder - Sr.
5 Years 5 Months
Coronis Ajuba Health Services | Chennai, TamilNadu | 06.2021 - Current
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.
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.
Medical Coder
10 Months
Deccan I Services | Trivandrum, Kerala | 12.2019 - 10.2020
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.
Transaction Analyst
1 Year 6 Months
Phykon Solutions, TVM | Trivandrum, Kerala | 05.2018 - 11.2019
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.
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.
Assistant Lecturer
3 Years 9 Months
MIMSR Medical College | Latur, Maharashtra | 02.2011 - 11.2014
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
Bachelor of Science - Nursing
Pioneer College of Nursing | Hyderabad | 07.2006 - 12.2010
Plus Two
Soccorso HSS | Mala | 06.2004 - 03.2006
S.S.L.C - 10th
St. Antony’s G.H.S | Thrissur | 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 Time
Location Preference
On-SiteRemote
Important To Me
Work-life balanceCompany CulturePaid sick leaveHealthcare benefitsCareer advancementWork from home optionFlexible work hoursTeam Building / Company Retreats