Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Riyanshi Maheshwari

Medical Coder

Summary

  • 1+ years of hands-on experience in E/M IP Medical Coding at Optum (a part of Unitedhealthgroup).
  • Proficient in E/M Inpatient, telehealth, ICD-10-CM, CPT, and HCPCS Level II coding systems.
  • Familiar with E/M CPT and Risk Adjustment coding. Demonstrated accuracy with 95%+ coding quality and daily productivity targets.
  • Strong knowledge of HIPAA, CMS guidelines, and payer-specific requirements.
  • Flexible in working with different software.

Overview

1
1
year of professional experience
1
1
Certification
2
2
Languages

Work History

Medical Coder

Optum(Unitedhealthgroup)
04.2024 - Current
  • Reviewed and analyzed patient medical records to assign appropriate ICD-10, CPT, and HCPCS codes.
  • Worked on risk adjustment and HCC coding for Medicare Advantage plans.
  • Ensured compliance with CMS and Optum-specific coding guidelines.
  • Achieved a consistent coding accuracy of over 95% as per internal audits.
  • Collaborated with providers and auditors for query resolutions.
  • Participated in ongoing coding education and quarterly assessments.
  • Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
  • Monitored changes in coding regulations to provide recommendations for compliance.

Education

Bachelor of Science - LifeSciences

Dr. BR Ambedkar University
Agra, UP
08.2023

Skills

  • Healthcare coding expertise
  • Knowledge of clinical terminology
  • Understanding of HIPAA standards
  • Identifying coding errors
  • Medical record documentation
  • ICD-10 coding

Certification

Certified Professional Coder(CPC) By AAPC

Timeline

Medical Coder

Optum(Unitedhealthgroup)
04.2024 - Current

Bachelor of Science - LifeSciences

Dr. BR Ambedkar University
Riyanshi MaheshwariMedical Coder