Padmavathy R

Work Summary – Oral and Maxillofacial Surgery (OMS) Coder & AR Specialist Key Skills & Responsibilities:

I am an experienced Oral and Maxillofacial Surgery (OMS) Coder with expertise in CPT, ICD-10, and HCPCS coding for oral and maxillofacial procedures. I ensure accurate coding, appropriate modifier application, and compliant claim submissions to maximize reimbursements. My proficiency extends to Office Ally Clearinghouse , where I manage claim submissions, rejections, denials, and AR follow-ups to optimize revenue cycle performance.

• Medical Coding & Compliance: Assign CPT, ICD-10, and HCPCS codes for oral and maxillofacial procedures while ensuring compliance with payer guidelines.
• Claim Processing & Revenue Cycle Management: Submit claims through Office Ally Clearinghouse , monitor status, identify rejection causes, and take corrective actions.
• Denial Management & Appeals: Analyze claim rejections and denials , make necessary corrections, resubmit claims, and handle appeals with supporting documentation to secure maximum reimbursement.
• Eligibility Verification & AR Management: Verify patient insurance benefits, track AR aging reports , and follow up on unpaid claims while maintaining detailed audit documentation .
• SOAP Note Documentation: Accurately document patient encounters using the SOAP format, ensuring clarity, completeness, and HIPAA compliance.
• Provider & Insurance Coordination: Work closely with healthcare providers and insurance companies to resolve billing issues, clarify documentation details, and ensure compliance with regulatory guidelines.

• 3 Yrs experience in US Medical Billing
• Platform: Eligibility, Demo Entry, Correspondence, Rejections, Vertical Discovery, Payment Posting, Denials, AR Analyzing, Appealing
• Worked in NextGen software, ECW, Veracity, Next cloud and US bank
• Taking appoint listing of patient and verifying Eligibility
• Clearing front end and back end rejections
• Downloading ERA's from Clearing House, posting payments, capturing denials and taking action for denials, Checking claim status in Insurance websites and allocating claims for calling team for further actions
• Giving priority to the aged and high dollar value claims
• Reviewed encounter forms for accuracy and completeness prior to data entry
• Make all charge corrections, edits, and billing errors to batches
• Coordinated relationships with other finance departments
• Consistently earned highest rating in customer service quality surveys
• Verified patient insurance and load insurance carrier and information accordingly
• Worked IVR Calling, Appeal for TFL Claims, Appeal with MR, Fax

• Coordinated in schedule creation, implementation and follow up activities specific to the services rendered by the company to the students for academic preparation
• Performed and coordinated academic and administrative activities for designated faculty members
• Developed, managed and maintained internal databases in support of academic departments
• Collaborated with program managers for project and report completion
• Monitored student performance on a frequent basis; identifying potential issues with data providing feedback and solutions to remediate issues
• Developed, reviewed and provided comments on student learning outcomes through appropriate follow ups
• Handled student grievances specific to academic services in collaboration with the Senior Mentor
• Collaborated with the Director of the company to provide assistance in lead marketing of FIITJEE Global School through effectual follow ups
• Provided overall administrative assistance to academic department leadership, faculty and administrative staff

• Started as a Montessori teacher for kindergarten school, contributed for moral and academic development of kids through innovative teaching techniques
• Heightened with responsibilities of handling primary school students in the subjects of computer science and science subjects
• Acted as a marketing professional by assisting the school to attain the targeted student strength and revenue

• Suggested engineering students with right choice of courses taught by the company for career options after taking them through an individualized consulting
• Efficiently managed data to keep a better track of the placement process for the students
• Handled a targeted sales quota of courses to be sold for the students
• Encouraged and assisted in the growth of education and skills for the students connecting them with leaders and professionals for inspiration

• Handled inbound calls addressing the customer queries and helped them in booking the products knowing their requirements
• Managed to keep records of customer interactions, transactions, complaints, comments as well as actions taken, order process
• Handled tough customers, understanding their dissatisfaction and suggested them the product which could bring satisfaction or delight to them
• Provided feedback of the customers to the management for product and service improvements