Mohana Ramya T
CPC-Certified Coder
Chennai,TN
Summary
Dedicated and detail-oriented Healthcare Professional with over 14+ years of experience in medical coding, denial management, resubmissions, and insurance coordination across leading hospitals and healthcare management firms in UAE and India. Proven expertise in claims resubmission, denial analysis, payer communication, and process automation. Recognized for strong leadership, analytical skills, and ability to reduce rejection rates, improve TAT, and ensure compliance with DHA/HAAD regulations. Results-driven professional with proven track record in supervising and optimizing team performance. Skilled in operational management and process improvement, consistently delivering high-quality outcomes. Known for strong leadership and adaptability in dynamic environments.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Senior Supervisor – Operations-Denial Management
Accumed Practice Management
Chennai
10.2018 - Current
- Supervising and led the team in reviewing, correcting, and submitting medical claims within payer deadlines.
- Monitored daily workload distribution to ensure timely completion of resubmissions and adherence to turnaround time (TAT).
- Ensured compliance with payer rules, regulatory requirements, and organizational policies during operational process.
- Maintained quality standards by conducting random audits and providing feedback to team members.
- Assisted management in process improvement initiatives to enhance process accuracy and reduce revenue loss.
- Supported escalations by coordinating directly with payers and internal stakeholders to ensure resolution.
- Mentored team members, managed performance, and motivated the team to achieve KPIs and departmental goals.
- Errors of respected team are been escalated in Management review meeting.
- Coordinated with coding, data entry, and reconciliation teams to resolve discrepancies and improve claim acceptance rates.
- Reviewed claim denial reasons and guided the team with corrective measures to minimize rejections.
- Tracked claim rejections and prepared periodic reports for management, highlighting trends and improvement areas.
- Conducted training and knowledge-sharing sessions for team members on updated payer guidelines and system changes.
- Collaborated with IT and Cerner support teams to resolve technical issues impacting resubmission workflows.
Senior Associate – Operations - Denial Management
Accumed Practice Management
Dubai
08.2017 - 10.2018
- Analysed rejections from XML Remittance Advice and escalated issues to supervisors and technical teams.
- Resubmitted claims with correct coding and formats per DHA standards.
- Coordinated with providers for supporting documentation (card copies, approvals).
- Ensured minimal final rejections by proactive follow-up and corrective actions.
- Consistently achieved resubmission productivity targets within TAT.
Insurance Coordinator – Resubmission
Lifeline Hospital
Dubai
03.2016 - 07.2017
- Reviewed XML remittance advices, identified rejection reasons, and prepared claims for resubmission.
- Liaised with doctors for medical justifications and ensured timely follow-up.
- Submitted corrected claims to insurance companies while maintaining compliance with payer rules.
- Ensured minimal rejection rates and timely achievement of resubmission targets.
Insurance Executive
Aster Jubilee Medical Complex
Dubai
09.2012 - 05.2015
- Submitted e-claims using ICD-10 codes through DHA site.
- Handled insurance eligibility, payments, approvals, and reconciliations.
- Resubmitted rejected claims and tracked their resolution.
- Assisted patients with queries on eligibility and claim status while maintaining confidentiality.
Clinical Pharmacist
Apollo Hospital (JCIA)
Chennai
01.2006 - 09.2009
- Supported medical staff with clinical pharmacy services and patient care.
- Ensured compliance with JCIA standards in documentation and patient safety.
Education
Bachelor of Pharmacy (B.Pharm) - undefined
01.2005
Higher Secondary Certificate - undefined
01.2001
Secondary School Certificate - undefined
01.1999
Skills
- Denial Management
- Resubmission Supervision
- Denial Prevention
- Resolution Strategies
- Clinical Documentation Improvement
- Gap Analysis
- Coding Quality Audits
- Compliance
- Policy Interpretation
- Guideline Updates
- Team Leadership
- Performance Monitoring
- Process Improvement
- Automation of Claims
- Stakeholder Communication
- Provider Communication
- Payer Communication
- Training
- Team Development
- Productivity Monitoring
- KPI-driven Performance Management
- MS Office Suite
- Healthcare Claim Platforms
Certification
CPC – Certified Professional Coder (AAPC)
Personal Information
Title: CPC-Certified Coder | Healthcare Revenue Cycle & Denial Management Specialist
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Senior Supervisor – Operations-Denial Management - Accumed Practice Management
10.2018 - Current
Senior Associate – Operations - Denial Management - Accumed Practice Management
08.2017 - 10.2018
Insurance Coordinator – Resubmission - Lifeline Hospital
03.2016 - 07.2017
Insurance Executive - Aster Jubilee Medical Complex
09.2012 - 05.2015
Clinical Pharmacist - Apollo Hospital (JCIA)
01.2006 - 09.2009
- Bachelor of Pharmacy (B.Pharm),
Tamil Nadu Board - Higher Secondary Certificate,
Tamil Nadu Board - Secondary School Certificate,