Summary
Overview
Work History
Education
Skills
Certification
Accomplishments
Personal Information
Disclaimer
Work Availability
Work Preference
Interests
Languages
Timeline
Krishnaraj M

Krishnaraj M

Assistant Manager - Medical Coding
Minjur,Chennai

Summary

Dynamic healthcare leader with 14 years' experience in US medical coding, revenue cycle management and payment integrity; specialized in HCC, home health, surgery coding and denial management. Certified CPC, PMP and Lean Six Sigma Green Belt, combining deep domain expertise with proven project management skills—project planning, stakeholder management, scope and timeline control, risk mitigation and resource allocation—to deliver cross-functional initiatives on time and within budget. Adept at leading teams, optimizing workflows and implementing process improvements that enhance coding accuracy, compliance and operational efficiency.

Overview

3
3
Certificates
5
5
years of post-secondary education
15
15
years of professional experience
3
3
Languages

Work History

Assistant Manager

EXL
Chennai
11.2025 - Current
  • Protected and recovered revenue by identifying and closing revenue leakage through targeted coding audits and process improvements.
  • Designed and implemented new coding queries, logic and coding solutions to address documentation gaps and reduce denials.
  • Conducted audit-based training and coaching for coders, developing targeted modules that improved coding accuracy and compliance.
  • Collaborated with RCM, CRC and clinical teams to resolve claims, prepare appeals and strengthen documentation workflows.
  • Implemented tracking reports and KPIs to monitor leakage, denial trends and recovery actions for continuous improvement.

Team Leader

Guidehouse India Pvt LTD
Chennai, India
03.2023 - 11.2025
  • Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed.
  • Developed team members' skills through targeted coaching sessions, resulting in improved individual performance.
  • Enhanced team productivity by implementing efficient work processes and regularly reviewing performance metrics.
  • Mentored junior staff members, helping them develop their leadership potential and advance in their careers.

Coding Audit Lead

Revele India Pvt LTD
Chennai
12.2015 - 03.2023
  • Collaborating with RCM and CRC team and providing coding guidelines to the client.
  • Enhanced audit efficiency by implementing risk-based audit procedures and methodologies.
  • Developed customized audit programs, addressing specific business needs and objectives.
  • Evaluated the effectiveness of implemented solutions post-audit, ensuring ongoing compliance with recommendations.
  • Led a team of auditors, fostering collaboration and promoting professional development among team members.

EXECUTIVE CODER

India Healthcare Solutions
Chennai
07.2014 - 09.2015
  • Reviewing plan of care such as SOC, ROC and REC
  • Capturing ICD-9 CM and ICD-10 CM and PCS codes based on admission
  • Analyzing patient medical history, Daily activities, Medications and updating OASIS sheets based on guidelines

EXECUTIVE CODER

Episource India Pvt LTD
Chennai
01.2012 - 07.2014
  • Reviewing Medical records of the patients and capturing HCC ICD-9 CM and DRG codes.
  • Responsible for Inpatient coding for the allocated claims such as surgery note, discharge summary, OT Notes, Medication charts, Lab reports, Radiology reports etc.
  • Working on rebuttals and auditing the charts adhering to state and client specific policy guidelines.

Education

Master of Science - Zoology

University of Madras, Chennai
07.2009 - 08.2011

Bachelor of Science - Biotechnology

University of Madras, Chennai
01.2006 - 06.2009

Skills

Project Management

Team Leadership and Mentoring

Risk and Quality Management

Revenue Cycle Management

Data-Driven decision making

Quality Improvement

Certification

CPC certified from AAPC, 01258943

Accomplishments

  • Nominated for Best Employee of the Year 2013, Episource India Pvt LTD.
  • Awarded Guiding Star for the Q4 2024 and Q2 2025, Guidehouse India Pvt LTD.

Personal Information

  • Date of Birth: 01-Nov-1988
  • Gender : Male
  • Nationality: Indian
  • Marital Status: Married

Disclaimer

I am hereby declaring that the above statements are true to the best of my knowledge and belief.

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference

Work Type

Full Time

Location Preference

Hybrid

Important To Me

Career advancementWork-life balanceFlexible work hoursHealthcare benefitsWork from home optionTeam Building / Company Retreats

Interests

Travelling

Watching Sports

Languages

English
Tamil
Hindi

Timeline

Assistant Manager - EXL
11.2025 - Current
Team Leader - Guidehouse India Pvt LTD
03.2023 - 11.2025
Coding Audit Lead - Revele India Pvt LTD
12.2015 - 03.2023
EXECUTIVE CODER - India Healthcare Solutions
07.2014 - 09.2015
EXECUTIVE CODER - Episource India Pvt LTD
01.2012 - 07.2014
University of Madras - Master of Science, Zoology
07.2009 - 08.2011
University of Madras - Bachelor of Science, Biotechnology
01.2006 - 06.2009

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Krishnaraj MAssistant Manager - Medical Coding