Mekala K.
Thiruvottiyur
Summary
Looking for an prudent carrier in contributing your organization success that will enable me to grow and take more responsibilities.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Quality Assurance Specialist
Optum Health And Technology India Pvt Ltd
Chennai
12.2022 - Current
- Reviewed application requirements to ensure comprehensive testing coverage.
- Derived effective QA sampling & audit methodology for the projects assigned
- Performed root cause analysis, identify knowledge gaps, and conduct training to project team
- Performed Quality Assurance for new clients and worked on pilot project delivery to meet client SLA on quality
- Reviewed & customized standard coding guidelines as needed
- Identified error trends on client feedback & improve training sessions on audit protocols, the comment matrix, and best practices for prospective auditors
- Responded to the internal coding queries with proper rationale
- Followed external and internal compliance standards
Senior Medical Coding Quality Control Auditor
AGS Health Pvt Ltd
06.2015 - 11.2022
- Conducted thorough audits of healthcare claims for accuracy in CPT, ICD -10-CM, ICD -10- HCPCS and compliance.
- Reviewed documentation to ensure adherence to regulatory standards and company policies.
- Collaborated with cross-functional teams to identify process improvement opportunities.
- Trained new staff on quality assurance protocols and auditing procedures.
- Developed and implemented quality control checklists for audit consistency.
- Analyzed audit results to determine areas for operational enhancement.
Senior Medical Coder
Omega Healthcare Management Services
07.2012 - 04.2015
Medical Coder
Omega Healthcare Management Services
11.2009 - 10.2011
Education
10th -
Vellayan Chettiar Hr.Sec.School
12th -
Vellayan Chettiar Hr.Sec.School
B.Sc - Microbiology
Dr.MGR Janaki College of Arts & Science for Women
MBA - Human Resource Management
Bharathiyar University Coimbatore
Certification
- CPC, AAPC, 05/2017, 72%
- CCS, AHIMA, 10/2019, 331 marks
Languages
- English
- Tamil
- English
Hobbies and Interests
- Cooking
- Reading books
- Painting
Disclaimer
I do hereby declare that the particulars of information and facts stated herein above are true, correct and complete to the best of my knowledge and belief.
Participated In
- The Chennai Science Festival, 2009, Anna University, Chennai - 600025
- National conference on 'Microbial Ecology, Biodiversity, Molecular Techniques and its Processes', Kandhaswami Kandar's College, Namakkal
- National Seminar on Bioscience - New Vistas, 2008, DR.MGR Janaki College
Personal Information
- Total Experience: 13+ years
- Date of Birth: 05/13/89
- Gender: Female
- Nationality: Indian
- Marital Status: Married
- Religion: Hindu
Timeline
Quality Assurance Specialist
Optum Health And Technology India Pvt Ltd
12.2022 - Current
Senior Medical Coding Quality Control Auditor
AGS Health Pvt Ltd
06.2015 - 11.2022
Senior Medical Coder
Omega Healthcare Management Services
07.2012 - 04.2015
Medical Coder
Omega Healthcare Management Services
11.2009 - 10.2011
10th -
Vellayan Chettiar Hr.Sec.School
12th -
Vellayan Chettiar Hr.Sec.School
B.Sc - Microbiology
Dr.MGR Janaki College of Arts & Science for Women
MBA - Human Resource Management
Bharathiyar University Coimbatore