LAVANYA VELURU
HYDERABAD
Summary
Dynamic Senior Medical Coder with expertise in ICD-10 and CPT coding at Quintessence Business and Services. Proven track record in denial management and claims submission, enhancing accuracy and compliance. Strong interpersonal skills foster collaboration, driving process improvements and ensuring high-quality outcomes in medical record documentation.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Senior Medical Coder in Multi Speciality Denial Coding Management
QUINTESSENCE BUSINESS AND SERVICES PVT LTD
CHENNAI
01.2022 - Current
- REVELE was acquired by Quintessence Company in January 2024 to present.
- Handled claims denied or rejected due to upcoding, downcoding, LCD/NCD rejections, and modifier issues.
- Reviewed patient medical records and coded CPT, ICD, and appropriate modifiers.
- Utilized tools like Codify to check combo codes for ICD, and modifiers.
- Checked ERA for remark codes to determine exact denial reasons, and referred to CCI edits for billed CPTs.
- Performed special projects with high quality.
- Submitted claims to insurance companies, and investigated rejected or denied claims.
- Rechecked claims to determine whether they were rejected or denied before submission.
- Conducted audits to ensure compliance with federal and state regulations.
- Coordinated with the billing department to clarify billing issues related to coding.
- Responded promptly to inquiries from internal customers regarding correct application of codes.
- Applied coding rules established by American Medical Association and Centers for Medicare and Medicaid Services for assignment of procedural codes.
- Reviewed medical records to identify diagnoses, procedures and services rendered for accurate coding.
- Proofread documents carefully to check accuracy and completeness of all paperwork.
- Interpreted medical reports to apply appropriate ICD-10, CPT, and HCPCS codes.
- Handled incoming calls and directed callers to appropriate department or employee.
- Monitored quality assurance activities within the department including tracking trends in denials due to incorrect or incomplete coding information.
- Purged inactive files and destroyed obsolete files following procedures.
- Provided feedback on potential process improvements related to medical record documentation.
- Managed coding for multiple specialties, ensuring specific codes are accurately applied.
- Transmitted information or documents to customers through email, mailings or facsimile machine.
- Interpreted medical terminology and pharmacological information to translate information into coding system.
- Verified proper coding, sequencing of diagnoses, and accuracy of procedures.
- Communicated with healthcare personnel, including practitioners to promote accuracy.
- Analyzed physician documentation to ensure accuracy of codes assigned in accordance with accepted coding guidelines.
- Reviewed account information to confirm patient and insurance information is accurate and complete.
- Performed periodic audits of coded data to ensure accuracy and compliance with established standards.
- Determined and implemented techniques to improve medical records retrieval process.
Senior Client Partner in Denial Coding Management
ACCESS HEALTHCARE SERVICES PVT LTD
07.2021 - 01.2022
- I used to work on the back-end process in order to process the claims that were denied or rejected due to upcoding, downcoding, LCD/NCD rejections, and modifiers.
- I used to work on the claims that were denied or rejected due to upcoding and downcoding, LCD/NCD rejections, and modifiers.
- Created customized solutions to meet the needs of clients based on their individual requirements.
- Kept confidential client information properly protected and only used for official purposes.
Medical Associate in Ambulance coding
TECHNO SOFT GLOBAL SERVICES PVT LTD
09.2020 - 07.2021
- Conduct audits and coding reviews to ensure all documentation is accurate and precise
- Being an subject matter expert helping the users with their queries, mainly on emails
Trainee in Medical Coding & Billing
OMEGA HEALTHCARE PVTLTD
07.2019 - 09.2020
- Worked as Trainee in Medical Coding & Billing
- Use to check patient Demographics, modifiers & Insurance details as per Patient Medical records
- Being an subject matter expert helping the users with their queries, mainly on emails
Education
B Pharmacy -
Annamacharya college of Pharmacy
Rajampet, India01.2019
Associate of Science - BIPC
Board of Intermediate Education
SRI CHAITANYA JUNIOR COLLEGE01.2014
High School Diploma -
Board of Secondary Education
SRI CHAKRA HIGH SCHOOL01.2012
Skills
- ICD-10 coding
- CPT coding
- Claims submission
- Denial management
- Medical record review
- Certified health data analyst (CHDA)
- Interpersonal skills
- Teamwork and collaboration
- Records accuracy
- Decision-making capacity
- Coding error resolution
- Patient data coding
- Medical billing
- Procedural coding
- ECW (E Clinical Works)
- Review records
- Clinical documentation
- Effective communication
- Data verification
- Patient data compilation
- Revenue cycle management
- Certified professional coder (CPC)
Languages
- English
- Telugu
- Hindi
Disclaimer
I do hereby declare that all the above-mentioned details are true to the best of my knowledge and belief.
Personal Information
- Date of Birth: 03/11/97
- Gender: Female
- Nationality: Indian
- Marital Status: Married
Certification
Certified Professional Coder (CPC)
Languages
Telugu
First Language
English
Advanced (C1)
C1
Hindi
Advanced (C1)
C1
Affiliations
Actively participated in Town Hall meetings and games on the work floor
Computer Knowledge
Gain experience with Windows 10 and 11 servers, as well as proficiency in MS Excel, Word, and PowerPoint
Timeline
Senior Medical Coder in Multi Speciality Denial Coding Management
QUINTESSENCE BUSINESS AND SERVICES PVT LTD
01.2022 - Current
Senior Client Partner in Denial Coding Management
ACCESS HEALTHCARE SERVICES PVT LTD
07.2021 - 01.2022
Medical Associate in Ambulance coding
TECHNO SOFT GLOBAL SERVICES PVT LTD
09.2020 - 07.2021
Trainee in Medical Coding & Billing
OMEGA HEALTHCARE PVTLTD
07.2019 - 09.2020
B Pharmacy -
Annamacharya college of Pharmacy
Associate of Science - BIPC
Board of Intermediate Education
High School Diploma -
Board of Secondary Education
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