Pujitha Reddy Vippala
Medicare Claims Specialist, Medical Coder
Summary
Dynamic medical coding professional with proven expertise at Optum Global Solutions, enhancing coding accuracy and streamlining claims processing. Skilled in ICD-10 and HCPCS coding, I excel in analytical thinking and teamwork, fostering compliance and continuous improvement. Recognized for mentoring peers and leading workshops that elevate team performance and efficiency.
Overview
5
5
years of professional experience
5
5
years of post-secondary education
Work History
Medical Coder
Optum Global Solutions
10.2022 - 02.2024
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Increased accuracy of claims submissions with thorough understanding of ICD-10, CPT, and HCPCS coding systems.
- Skilled at working independently and collaboratively in a team environment.
- Worked well in a team setting, providing support and guidance.
- Managed time efficiently in order to complete all tasks within deadlines.
- Organized and detail-oriented with a strong work ethic.
- Used strong analytical and problem-solving skills to develop effective solutions for challenging situations.
Medicare Claim Specialist
Optum Global Solutions
10.2018 - 09.2022
- Organized and led workshops on best practices in claim handling, elevating team's overall performance.
- Established strong relationships with external adjusters to streamline external review process.
- Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information.
- Streamlined claims adjudication procedures, resulting in more consistent and fair claim outcomes.
- Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
- Mentored junior team members by providing guidance on navigating complex claim scenarios efficiently.
- Maintained up-to-date knowledge of coding guidelines and regulations, ensuring compliance across all coding activities.
- Supported compliance initiatives by participating in regular audits, identifying areas for improvement, and making necessary adjustments to processes.
- Supported successful reimbursement claims by accurately assigning appropriate ICD-10-CM, CPT, and HCPCS codes to medical records.
- Enhanced team productivity by providing ongoing training in ICD-10-CM, CPT, and HCPCS code sets as needed.
- Strengthened communication skills through regular interactions with others.
- Demonstrated respect, friendliness and willingness to help wherever needed.
Education
Bachelors of Physiotherapy - Health Education
Apollo Hospitals Education And Research Institute
Hyderabad, India 12.2013 - 06.2018
Skills
Medical terminology
Timeline
Medical Coder
Optum Global Solutions
10.2022 - 02.2024
Medicare Claim Specialist
Optum Global Solutions
10.2018 - 09.2022
Bachelors of Physiotherapy - Health Education
Apollo Hospitals Education And Research Institute
12.2013 - 06.2018
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