Manisha Eknath Mane
Summary
Dynamic operations leader with extensive experience at Cotiviti India, excelling in team leadership and process improvement. Proven track record in outpatient denial management,coding validation and inpatient coding and optimizing service delivery, achieving over 98% accuracy. Adept at mentoring teams and enhancing operational efficiency through strategic guidance and effective communication.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Team Lead Operations Coding Validation
Cotiviti India Private Ltd,
Coimbatore
01.2026 - Current
- Led cross-functional teams to enhance service delivery and operational efficiency.
- Coordinated project timelines and resources to align with client requirements.
- Project managed - mainly denial management for the below mentioned clients HCSC,Aetna, Horizon, Blue cross blue shield clients Provided leadership and guidance to team members, ensuring that tasks were completed on time and to a high standard.
- For all the above clients worked on claims and appeal processing and leading team of 45 analysts for this clients Project
- Implemented quality assurance measures to maintain consistent service standards.
- Mentored junior team members on best practices and process improvements.
- Analyzed workflow processes and identified areas for optimization and support.
- Resolved client inquiries promptly, contributing to high satisfaction levels across services.
- Coordinated communication between departments to streamline operations and resolve issues.
- Managed resource allocation to ensure timely project execution and delivery.
Clinical Validation Team Coach
Cotiviti India Private Ltd
Coimbatore
02.2023 - 12.2025
- Managed a team of 30 clinical analysts, overseeing daily operations and ensuring alignment with organizational goals.
- Analyzed team errors and conducted sessions to identify root causes, educating the team on updates and guidelines while addressing disconnects with the onshore team.
- Coordinate process training with onshore team for new hires.
- Delegated tasks among production team members to ensure efficient workflow.
- Organized team activities to ensure timely completion of daily production tasks with high accuracy.
- Managed team activities in Coimbatore while collaborating with the operations team in Pune.
- Facilitated team bonding activities and provided constructive feedback to enhance team performance.
Senior Clinical Analyst
Cotiviti India Private Ltd
Pune
11.2019 - 01.2023
- Reviewed claims at rate of 140 per hour with TAT of 4 hours, adjudicating various CPT combinations and modifier usage based on guidelines.
- Reviewed appeals at rate of 10 per hour with TAT of 7 days, analyzing member charts, lab, and consult reports to ensure correct CPT code adjudication.
- Ensured high accuracy level of over 98% in coding and claims review.
- Applied correct coding initiatives and guidelines to maintain compliance and accuracy in claims processing.
Medical Coding Analyst
Cotiviti India Private Ltd
Pune
05.2017 - 11.2019
- Audited claims for Horizon BCBSNJ, focusing on E&M, ED, and modifiers 25 and 59 to ensure coding accuracy.
- Mentored new team member in medical coding processes to enhance team knowledge and performance.
- Resolved medical coding queries within the team, facilitating timely and accurate claim submissions.
Medical Coding Analyst
EZDI Healthcare Data Intelligence
Pune
05.2016 - 03.2017
- Executed ICD10 CM, ICD 10 PCS, CPT, and HCPCS coding to ensure accurate medical record documentation.
- Conducted inpatient and emergency department coding to ensure accurate billing.
- Conduct a comprehensive review of clinical history by following CMS guidelines. Develop clinical rules to improve the coding platform based on CMS update on coding for US Healthcare Companies.
- Analysis of test runs conducted by CAC based on ICD 10 PCS.
- Guided NLP engineers in software development and table creation to optimize output from CAC.
- Sustained high productivity levels while ensuring quality standards in coding tasks.
Medical Coding Analyst
3Gen Consulting India Pvt Ltd
Pune
12.2014 - 03.2016
- Coded and audited home health, hospice, and D/C OASIS reports to ensure compliance with ICD-10CM coding guidelines.
- Worked on ICD 9 CM and ICD 10 CM coding.
- Conducted detailed research and analysis of patient charts to ensure accurate and compliant coding.
- Maintaining abreast of clinical coding standards, reporting and information policies according to CMS Standards and requirements.
- Reviewed rejected claims from clients and resubmitted them according to established guidelines to facilitate timely reimbursement.
- Acquired extensive knowledge of human anatomy and medical terminology through formal education and practical experience.
- Applied effective analogies to improve understanding of surgical coding procedures.
Medical Practitioner
01.2008 - 08.2014
- Medical Practitioner on General medicine.
- Facilitated antenatal care sessions for expectant mothers, ensuring health monitoring and support throughout pregnancy.
- Conducted dietary counseling sessions for chronic disease patients to promote healthier lifestyle choices and disease management.
Registered Medical Officer
Vasai Charitable Hospital
Thane
08.2005 - 10.2007
- Managed emergency, trauma, and general patients in outpatient and inpatient departments, ensuring timely and effective care.
- Conducted case assessments, provided treatment, and monitored and reported adverse events during clinical studies.
- Assisted in operation theater for caesarean sections, hysterectomy, laparoscopic procedures, tuboplasty, orthopedic surgeries, and general surgeries, contributing to successful patient outcomes.
Assistant Medical Officer
Vasai Municipal Hospital
Thane
01.2003 - 05.2005
- Led patient consultations in outpatient and inpatient departments, ensuring comprehensive care.
- Provided consultations in Allopathic, Ayurveda, and Panchakarma treatments, integrating diverse medical approaches for holistic patient care.
- Conducted case taking and treatment, monitored, recorded, and reported adverse events during case studies to enhance patient safety.
- Clinical professional with excellence in Clinical theoretical and Practical knowledge.
Education
B.A.M.S. -
Mumbai University
01-2003
H.S.C. -
Maharashtra State Board
01-1997
S.S.C. -
Maharashtra State Board
01-1995
Skills
- Inpatient Coding Proficiency
- Home Health coding
- CPT
- ICD-10-CM
- ICD-10 PCS
- HCPCS
- Revenue Cycle Management
- Coding standards
- Clinical information system
- Data Analysis Tools
- Process improvement
- Team leadership
- Team building
- Communication Platforms
- Medical terminology
Certification
- Certified Medical Coder from AAPC (CPC), ICD-10 proficient
- Board Certified Home Health Coder (BCHH-C)
- Certified on CIC certification course from AAPC
Disclaimer
I hereby declare that all the particulars stated above are correct to the best of my knowledge and belief.
Languages
English
Advanced
C1
Hindi
Proficient
C2
Marathi
Beginner
A1
Timeline
Team Lead Operations Coding Validation
Cotiviti India Private Ltd,
01.2026 - Current
Clinical Validation Team Coach
Cotiviti India Private Ltd
02.2023 - 12.2025
Senior Clinical Analyst
Cotiviti India Private Ltd
11.2019 - 01.2023
Medical Coding Analyst
Cotiviti India Private Ltd
05.2017 - 11.2019
Medical Coding Analyst
EZDI Healthcare Data Intelligence
05.2016 - 03.2017
Medical Coding Analyst
3Gen Consulting India Pvt Ltd
12.2014 - 03.2016
Medical Practitioner
01.2008 - 08.2014
Registered Medical Officer
Vasai Charitable Hospital
08.2005 - 10.2007
Assistant Medical Officer
Vasai Municipal Hospital
01.2003 - 05.2005
B.A.M.S. -
Mumbai University
H.S.C. -
Maharashtra State Board
S.S.C. -
Maharashtra State Board