Remseena P A
Kerala
Summary
Detail-oriented Senior Medical Coder with over 12 years of experience in medical coding and revenue cycle management across US and UAE healthcare systems. Expertise includes E&M/multispecialty coding, emergency department, HCC, surgery, pain management, and radiology. Proven skills in coding accuracy, documentation review, claim validation, and staff mentoring, ensuring compliance and optimizing reimbursement processes.
Overview
1
1
Certification
14
14
years of professional experience
Work History
Senior Medical Coder
QWay Technologies
03.2022 - Current
- Coded and abstracted patient encounters, focusing on evaluation & management, denials, and obstetrics & gynaecology to ensure accurate documentation.
- Review medical records and supporting documentation for diagnosis, procedures and treatment results; identify documentation deficiencies and required corrections.
- Apply insurance and reimbursement guidelines to code sequencing, medical necessity and coverage review.
- Collaborated with claims staff and physicians to correct draft reports and ensure timely submission of approved reports.
- Served as a resource and subject matter expert for coding staff while supporting special projects to enhance coding accuracy.
Senior Associate Coder
Accumed Practice Management
08.2018 - 03.2022
- Performed end-to-end UAE medical coding and claims-related activities across multispecialty and outpatient environments.
- Validated claims before submission, corrected pre-submission errors, and completed live claims within TAT requirements.
- Checked service approvals, coverage and medical necessity through insurance portals and applied applicable insurance guidelines.
- Reviewed documentation to identify deficiencies, supported report corrections, and coordinated with claims teams and physicians to ensure compliance and accuracy.
- Provided ongoing training and served as subject-matter resource for coding staff, enhancing team's coding accuracy and knowledge.
Auditor
SCIO Health Analytics
11.2017 - 08.2018
- Audited Evaluation & Management coding for multispecialty records to ensure compliance with documentation, code sequencing, medical necessity, and reimbursement standards.
- Analyzed medical records to identify documentation deficiencies, contributing to quality and accuracy enhancements.
- Served as a coding resource, facilitating special projects to support coding accuracy and compliance.
Senior Medical Coder
Wave Code Logix Private Limited
04.2015 - 11.2017
- Executed US medical coding for Emergency Department professional and facility encounters, ensuring accurate representation of services for optimal reimbursement.
- Applied coding and insurance guidelines, reviewed documentation, supported reimbursement requirements, and identified documentation deficiencies.
- Coordinated coding corrections and upheld quality standards, consistently meeting delivery timelines.
Senior RCM Coder
Omega Health Care Management Services
03.2014 - 04.2015
- Managed Emergency Department professional coding for Aristo, performing encounter abstraction, documentation review, code sequencing, and reimbursement analysis to ensure compliance and optimize revenue.
- Reviewed medical records to ensure accurate and timely coding of encounters, contributing to efficient claims processing.
- Reviewed patient records to ensure accurate coding and compliance standards.
- Collaborated with healthcare teams to clarify documentation for coding accuracy.
- Utilized coding software to assign appropriate medical codes for billing.
Senior Customer Service Executive
Serco
11.2012 - 03.2014
- Led customer service team to enhance client satisfaction and support efficiency.
- Resolved complex customer inquiries using advanced problem-solving skills and tools.
- Trained new representatives on company policies and customer interaction techniques.
- Managed medical records and coding processes to ensure accurate and timely service delivery.
- Supported ICD coding and HCC-related work to enhance customer service operations in healthcare environment.
Education
Nursing -
Eben-Ezer College of Nursing
Bangalore, India01-2012
Skills
- US Medical Coding
- UAE Medical Coding
- Multispecialty coding
- ED Professional & Facility
- HCC Coding
- OB/GYN
- Surgery and Pain Management
- Radiology
- ICD-10-CM
- CPT & HCPCS
- Medical necessity
- Quality auditing
- Claims coordination
- Revenue management
- Error correction
Technical Environment
- Athena
- Citrix
- EClinicWorks (ECW)
- Billing System
- SCIO Mine
- Optum
- Aristo
Certification
CPC Certified
Personal Information
Title: Senior Medical Coder
Languages
- English
- Malayalam
- Tamil
- Kannada
- Hindi
- Telugu (spoken)
Certifications Education
- CPC (Certified Professional Coder), 2014
- Diploma in General Nursing, Eben-Ezer College of Nursing, Bangalore, India, 2012, 87%
- Comprehensive Medical Coding Training, Achievers Spot, 3 months, Medical Terminology, Anatomy, Physiology & Pathology, ICD-10-CM, CPT & HCPCS, E&M, Radiology, Anesthesia & Pathology Coding, Revenue Cycle Management, HIPAA Compliance
Core Expertise
- US Medical Coding
- UAE Medical Coding
- E&M / Multispecialty Coding
- ED Professional & Facility
- HCC Coding
- Surgery & Pain Management
- Radiology
- OB/GYN
- Denials & Claims
- Outpatient & Submissions
- Documentation Review
- Auditing & Quality
- ICD-10-CM
- CPT & HCPCS
- Revenue Cycle Management
- Medical Necessity & Coverage
- Claim Validation
- TAT / Productivity
- Physician & Claims Coordination
- SME / Staff Training
- Pre-submission Error Correction
Timeline
Senior Medical Coder
QWay Technologies
03.2022 - Current
Senior Associate Coder
Accumed Practice Management
08.2018 - 03.2022
Auditor
SCIO Health Analytics
11.2017 - 08.2018
Senior Medical Coder
Wave Code Logix Private Limited
04.2015 - 11.2017
Senior RCM Coder
Omega Health Care Management Services
03.2014 - 04.2015
Senior Customer Service Executive
Serco
11.2012 - 03.2014
Nursing -
Eben-Ezer College of Nursing