MAANVI JAIDEEP
New Delhi
Summary
Certified Medical Coder with 3.8 years of experience in accurate medical coding, revenue cycle management, and healthcare compliance. Expertise in ICD-10, CPT, and HCPCS coding with a strong understanding of medical terminology, anatomy, and payer regulations. Adapt at leveraging AI-powered tools and automation to improve coding accuracy, streamline billing processes, and optimize reimbursements. Seeking to apply innovative solutions and data-driven insights in a progressive healthcare environment.
Overview
4
4
years of professional experience
1
1
Certification
Work History
Senior Clinical Investigator (SSE/TPR Auditor)
Optum Global solutions
Optum Global Solutions
06.2023 - Current
- Utilise AI-powered coding tools to assign accurate medical codes for diagnoses, procedures, and services using ICD-10, CPT, and HCPCS.
- Review and verify patient records with AI-assisted audits for enhanced compliance, accuracy, and precision.
- Strong understanding of healthcare regulations, compliance standards, and reimbursement methodologies.
- Collaborate with healthcare providers and AI-driven analytics to optimise coding accuracy and reimbursement rates.
- Prevent the payment of potentially fraudulent and/or abusive claims, utilising medical expertise, knowledge of CPT/ICD, and CMS guidelines.
- Use analytical and critical thinking skills for identifying coding and documentation discrepancies.
- Effective communication for providing feedback and recommendations to coding, and clinical staff.
- Participate in quality assurance activities.
- Worked on various Excel reports, such as root cause analysis, EPF vs CDM report, and deficit report.
Clinical Investigator
Optum Global solutions
Gurgaon
08.2021 - 05.2023
- Proficient in ICD-10-CM, CPT, and HCPCS Level II coding systems.
- Conduct medical record review to evaluate the quality and appropriateness of medical care provided.
- Identify potential areas for improvement in clinical documentation and coding practices.
- Maintain up-to-date knowledge of AI-driven coding solutions, payer policies, and regulatory changes.
- Assist in training new hires, and integrating AI-assisted coding tools into workflows.
- Conduct audits for the training batches.
Education
Bachelors of Physiotherapy (BPT) - Physiotherapy
Delhi Pharmaceutical Science And Research Universi
Pushp Vihar, New Delhi08-2020
High School Diploma -
A.E.S.DR.K.R.B. Memorial School
Pushp Vihar, New Delhi05-2016
Skills
- AI-driven medical coding automation
- ICD-10, CPT, and HCPCS coding
- Medical billing and revenue cycle management
- Knowledge of payer policies and regulatory compliance (Medicare, Medicaid, and private insurers)
- Electronic Health Records (EHR), and AI-based Practice Management Systems
- Medical terminology, anatomy, and pathophysiology
- Auditing, quality assurance, and AI-assisted documentation review
- HIPAA compliance and risk mitigation
- Denial management, appeals processing, and predictive analytics
- MS Office: PowerPoint, Excel, Word
- Effective public speaking
Certification
- Certified Professional Coder (CPC) - AAPC
- Lean certified
- Manual Lymphatic drainage
- PNF
Timeline
Senior Clinical Investigator (SSE/TPR Auditor)
Optum Global solutions
06.2023 - Current
Clinical Investigator
Optum Global solutions
08.2021 - 05.2023
Bachelors of Physiotherapy (BPT) - Physiotherapy
Delhi Pharmaceutical Science And Research Universi
High School Diploma -
A.E.S.DR.K.R.B. Memorial School