KRISHNARAJ M
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
1
1
Certificate
15
15
years of professional experience
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 coding queries and solutions to address documentation gaps, leading to reduced denials.
- Conducted training and coaching for coders, developing targeted modules that enhanced coding accuracy and ensured compliance.
- Implemented tracking reports and KPIs to monitor leakage and denial trends, facilitating continuous recovery improvements.
Team Leader
Guidehouse India Pvt LTD
Chennai
03.2023 - 11.2025
- Enhanced team productivity by implementing efficient work processes and regularly reviewing performance metrics.
- Established team performance expectations, monitored goal progress, and delivered constructive feedback to enhance accountability.
- Developed team members' skills through targeted coaching sessions, resulting in improved individual performance.
- Mentored junior staff, fostering leadership development and supporting career advancement opportunities.
Coding Audit Lead
Revele India Pvt LTD
Chennai
12.2015 - 03.2023
- Enhanced audit efficiency by implementing risk-based audit procedures and methodologies.
- Developed customized audit programs aligned with business needs, driving targeted improvements.
- Collaborated with RCM and CRC teams to provide tailored coding guidelines, enhancing client compliance.
- Evaluated effectiveness of solutions post-audit, ensuring adherence to compliance recommendations.
- Led a team of auditors, fostering collaboration and promoting professional development among team members.
Executive Coder
India Health Care Solutions
Chennai
07.2014 - 09.2015
- Captured ICD-9 CM, ICD-10 CM, and PCS codes at admission to facilitate accurate billing and patient records.
- Reviewed plans of care including SOC, ROC, and REC to ensure compliance and quality of patient care.
- Analyzed patient medical histories and documented daily activities to maintain comprehensive care records and updated OASIS sheets per guidelines.
Executive Coder
Episource India Pvt LTD
Chennai
01.2012 - 07.2014
- Reviewed medical records and captured HCC ICD-9 CM and DRG codes to ensure accurate coding compliance.
- Conducted rebuttals and audited charts to adhere to state and client-specific policy guidelines.
- Led strategic initiatives to enhance patient care delivery and operational efficiency.
- Developed and implemented policies to ensure compliance with healthcare regulations and standards.
- Collaborated with cross-functional teams to improve service quality and patient satisfaction metrics.
Education
Master of Science - Zoology
University of Madras
Chennai08-2011
Bachelor of Science - Biotechnology
University of Madras
Chennai06-2009
Skills
- Project Management
- Revenue Cycle Management
- Risk management
- Process improvement
- Data-driven decisions
- Quality assurance
- Team leadership
Certification
- CPC from AAPC, 2013
- LSSGB from CSSC, 2025
- PMP from PMI, 2026
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 Health Care Solutions
07.2014 - 09.2015
Executive Coder
Episource India Pvt LTD
01.2012 - 07.2014
Bachelor of Science - Biotechnology
University of Madras
Master of Science - Zoology
University of Madras
Travelling
Tr
Hobbies
- Travelling
- Watching Sports