MOHIT KUMAR SHARMA
Ghaziabad
Summary
Experienced healthcare and medical coding professional with over 10 years of expertise in CPT, ICD-10-CM, HCPCS, and PCS coding systems. Proven ability in managing coding audits, crosswalk development, publication workflows, and federal data alignment. Demonstrated success in leading a team of 5 coders, overseeing file creation, automation, and quality review processes. Adept at leveraging AI tools such as ChatGPT and Python automation to streamline coding operations, enhance productivity, and support process re-engineering. Strong understanding of the US healthcare system with a strategic focus on operational excellence and innovation.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Senior Medical Coder
AAPC India Pvt. Ltd.
Noida
10.2019 - Current
- Led a team of 5 medical coders, managing workflows for CPT/ICD/HCPCS crosswalks, audit checks, and client file delivery.
- Oversaw all updates on AAPC Codify.com, ensuring coding accuracy and regulatory compliance.
- Developed AI-assisted tools using ChatGPT and Python to automate publication auditing, CMS data parsing, and Excel report generation.
- Conducted thorough audits of CPT Assistant and Coding Clinic content, managing upload cycles and quality review.
- Created and delivered 80+ custom-coded data files monthly to over 120 clients.
- Initiated process automation projects that reduced manual workload by 70%.
- Used JIRA to file and track development tickets based on CMS and AMA data updates.
Executive - Medical Coding
ELI Research India
Faridabad
10.2014 - 09.2019
- Worked across CPT, ICD-10-CM, and HCPCS-based coding workflows, supporting quality audits and coding accuracy.
- Automated MIS reporting using Excel macros and Python scripts to support operational analysis.
- Trained junior coders on cross-functional coding guidelines and US healthcare documentation.
- Participated in cross-functional automation projects involving Excel and data transformation.
Fraud Investigator (Medical Coding & Compliance)
United Health Group
Noida
10.2012 - 09.2014
- Conducted quality checks and audits of coding-related claims for fraud detection.
- Handled appeals and reconsiderations involving denied CPT/ICD codes with accurate re-review.
- Trained new hires on fraud investigation and US healthcare system compliance.
- Created Excel-based tools to analyze trends in coding and claim outcomes.
Quality Compliance Analyst
EXL Service Pvt. Ltd.
Noida
04.2009 - 09.2012
- Reviewed coding-related claims data to ensure compliance with client billing policies.
- Delivered weekly and monthly dashboards on coding accuracy and provider data checks.
- Participated in calibration calls and coding quality alignment sessions with QA teams.
Education
MBA - Operations
Sikkim Manipal University
Gangtok, India01.2012
B.Com - Accounting
Ch. Charan Singh University
Meerut, India01.2008
Intermediate - Accounting
CBSE Board
Delhi, India01.2005
High School -
CBSE Board
Mumbai, India01.2003
Skills
- Medical Coding & Compliance: CPT, ICD-10-CM, HCPCS, ICD-10-PCS, NCCI Edits, CMS Guidelines, AMA CPT Assistant, AHA Coding Clinic
- Automation & Tools: Python (pandas, openpyxl), ChatGPT (API/LLM Integration), Excel VBA, JIRA, Regex, Task Scheduler
- Team Leadership: Mentoring, task assignment, peer review, performance tracking
- Reporting & Analysis: Dashboards, MIS Reports, VLOOKUP, PivotTables, Charts, Data Validation
- Process Improvement: Audit trails, publication review, crosswalk automation, federal data updates
- Platforms: AAPC Codifycom, CMSgov, MS Office, JIRA, Trello
Certification
- Certified Professional Coder (CPC), AAPC
- Completed 'Rush' Program, US Healthcare System and Medical Coding Compliance
- MIPS MACRA
Personal Information
Technical Coding Projects
- Crosswalk Automation Tool, Developed Python-based tool to auto-map CPT to ICD/HCPCS, reducing manual lookup by 80%.
- Publication Audit Assistant, Integrated ChatGPT to generate lay summaries and audit content consistency.
- CMS Scraper Utility, Automated federal data extraction from CMS portals for quarterly updates using Python.
Languages
- English
- Hindi
Timeline
Senior Medical Coder
AAPC India Pvt. Ltd.
10.2019 - Current
Executive - Medical Coding
ELI Research India
10.2014 - 09.2019
Fraud Investigator (Medical Coding & Compliance)
United Health Group
10.2012 - 09.2014
Quality Compliance Analyst
EXL Service Pvt. Ltd.
04.2009 - 09.2012
MBA - Operations
Sikkim Manipal University
B.Com - Accounting
Ch. Charan Singh University
Intermediate - Accounting
CBSE Board
High School -
CBSE Board
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