Mekala Kumar
Chennai
Summary
Looking for a prudent carrier in contributing to your organization's success that will enable me to grow and take more responsibilities.
Highly skilled Coding Quality Analyst with Proven results and comprehensive experience in reviewing, auditing, and analyzing medical coding. Possess strong skills in ensuring compliance with coding policies and guidelines across multiple healthcare systems.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Quality Assurance Specialist
Optum Health and technology
Chennai
12.2022 - Current
- Developed and maintained quality assurance protocols, processes and procedures.
- Reviewed clinical documentations and analyses the errors in clinical documents.
- Expertise in ICD 10 CM, CPT, HCPCS, ICD 10 PCS Coding.
- Performed root cause analysis of defects identified during testing cycles.
- Provided feedback on errors based on auditing results.
- Maintained knowledge of current industry developments and regulatory requirements for quality assurance purposes.
- Handling sampling process and feedback mechanism.
Senior Medical Coding Quality Control Auditor
AGS Health Pvt Ltd
Chennai
06.2015 - 11.2022
- Senior Second level Quality Auditor in Emergency Department Professional and Facility, Radiology, Ancillary, departments
- Expertise in ICD 10 CM, CPT, HCPCS, ICD 10 PCS coding.
- Audition all types of Medical record
- Conducted internal process audits to ensure adherence to company's quality policies and compliance with quality standards.
Senior Medical Coder
Omega Healthcare Management Services
Chennai
07.2012 - 04.2015
- Reviewed medical records to identify diagnoses, procedures and services rendered for accurate coding.
- Analyzed physician documentation to ensure accuracy of codes assigned in accordance with accepted coding guidelines.
- Trained new coders on proper use of ICD-10 codes and CPT codes.
- Performed periodic audits of coded data to ensure accuracy and compliance with established standards.
- Maintained current knowledge of industry changes related to ICD-10, CPT, HCPCS codes by attending seminars and webinars.
- Added modifiers as appropriate, coded narrative diagnoses and verified diagnoses.
- Resolved complex reimbursement issues related to coding practices.
Medical coder
Omega Healthcare Management Services
- 10.2011
Education
MBA Human Resource Management - Human Resources Management
Bharathiyar University Coimbatore
05-2015
B.Sc Microbiology -
Dr.MGR Janaki College of Arts & Science for Women
Chennai05-2009
12th - Microbiology
Vellayan Chettiar Hr.Sec.School
Chennai04-2006
10th -
Vellayan Chettiar Hr.Sec.School
Chennai01.2004
Primary Schooling To 5th Std - Basic Schooling
Sri Ram Dayal Khemka Vivekananda Vidhyalaya
Chennai05-1999
Skills
- Quality Assurance
- Risk Management
- Correction action planning
- Sampling
- Performance monitoring
- Communication proficiency
- Team management
- Root cause analysis
- Process management
- Decision-Making
Certification
- CPC, AAPC, 72%, 05/2017
- CCS, AHIMA, 10/2019
Religion
Hindu
Sex
Female
Maritalstatus
Married
Participatedin
- The Chennai Science Festival in 2009 was held at Anna University, Chennai 600025.
- National conference on Microbial Ecology, Biodiversity, Molecular Techniques, and its Processes organized under the auspices of the CSIR & DST New Delhi held at Kandhaswami Kandar's College, Namakkal.
- National Seminar on Bioscience New Vistas in 2008 at DR.MGR Janaki College.
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.
Father'sname
N. Kumar
Personal Information
- Total Experience: 13+ years of experience in Medical Coding Emergency Department
- Date of Birth: 05/13/89
- Nationality: Indian
Languages
English
Proficient
C2
Tamil
Proficient
C2
Hindi
Elementary
A2
Timeline
Quality Assurance Specialist
Optum Health and technology
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
- 10.2011
MBA Human Resource Management - Human Resources Management
Bharathiyar University Coimbatore
B.Sc Microbiology -
Dr.MGR Janaki College of Arts & Science for Women
12th - Microbiology
Vellayan Chettiar Hr.Sec.School
10th -
Vellayan Chettiar Hr.Sec.School
Primary Schooling To 5th Std - Basic Schooling
Sri Ram Dayal Khemka Vivekananda Vidhyalaya