Krishna Chaitanya K
Chennai
Summary
Experienced Quality Auditor with expertise in data analysis, visualization, and conducting detailed audits. Skilled at identifying process inefficiencies and implementing corrective actions. Exceptional attention to detail and critical thinking abilities. Proven track record of contributing to significant improvements in quality processes.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Quality Auditor
APM Medical billers Pvt Ltd
Dubai
02.2024 - Current
- Conducted rigorous daily quality audits on coder claims, providing constructive feedback to enhance quality and accuracy. Improved coding quality through targeted feedback and continuous monitoring.
- Data-Driven Insights: Developed and presented comprehensive weekly and monthly analysis reports to management, highlighting areas of improvement for coders and informing data-driven decisions to drive business growth.
- Data Automation & Forecasting: Successfully automated data processes using Excel and Python, enabling accurate forecasting of RCM revenue and loss. Identified data trends, made predictions, and took preventive actions to optimize financial performance.
Insurance Coordinator
Belhoul hospitals
Dubai
12.2019 - 11.2020
- Handle insurance claims, payments, and prior authorizations following established protocols and procedures.
- Verify and update insurance information and authorizations to avoid expiration and denial of claims.
- Investigate and resolve denied claims using billing office resources and tools.
- Generate and analyze reports on claims status, revenue cycle, and lost revenue, and implement strategies to reduce losses.
- Compile data for weekly and monthly reports on claims approvals, denials, and pending claims.Interpret medical information and procedures for each visit and sequence the correct ICD 10 CM and CPT codes.
In Patient Coder
Atos Syntal
Chennai
10.2016 - 10.2019
- Worked with clinical and quality teams to validate MS-DRG, patient safety indicators, and hospital-acquired conditions based on physician documentation for proper coding.
- Created coding queries to ask for clarification on physician documentation when needed.
- Coded diseases and procedures accurately according to clinical documentation and official coding guidelines for inpatient hospital accounts.
- Followed AHIMA's guidelines to code diseases and procedures and assign the right DRG for each case.
Education
BTech - Bio Medical Engineering
JNTUK
Kakinada08-2014
Skills
- Data analysis skills
- Data Visualization and Presentations
- Revenue cycle management (RCM)
- Microsoft Office Tools
- HIPAA Compliance
- Tableau
- Jupyter Notebook Python
- Statistical Analysis
- MS-DRGs
- ICD - 10 CM
- CPT Codes
- ICD-10 PCS
- Team Mentoring
Certification
- Analyzing and Visualizing Data with Microsoft Excel
- AI Data Automation
- Certified Professional Coder (CPC)
Timeline
Quality Auditor
APM Medical billers Pvt Ltd
02.2024 - Current
Insurance Coordinator
Belhoul hospitals
12.2019 - 11.2020
In Patient Coder
Atos Syntal
10.2016 - 10.2019
BTech - Bio Medical Engineering
JNTUK
- Analyzing and Visualizing Data with Microsoft Excel
- AI Data Automation
- Certified Professional Coder (CPC)
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