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, UP08.2023
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
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