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
Coding error resolution
HIPAA compliance
Clinical documentation
Diagnostic coding
HCPCS coding
Revenue cycle management
Procedural coding
Workflow management
Claims processing
Records management
Healthcare claim coding
Microsoft Excel
ICD-10 coding
Teamwork and collaboration
Analytical thinking
3M encoder
Home health coding
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