Selvaganapathy Venkateshwaran
Coimbatore
Summary
Team Leader in Coding Services with 8 years of experience in HCC, Anesthesia, and E/M coding across Medicare Advantage and ACA risk adjustment programs. Highly skilled in ICD-10-CM coding, quality reviews, and audits, ensuring full compliance with CMS HCC guidelines. Proven leadership as a Team Leader and Group Coordinator, managing teams to meet quality benchmarks and delivering tailored reports to stakeholders.
Strong in strategic planning, problem-solving, and effective communication, with proficiency in Microsoft Office tools. Career progression includes roles such as Medical Coder – Quality Analyst and Senior Officer, showcasing deep expertise in medical coding, billing procedures, and healthcare operations. Dedicated to HIPAA compliance and continuous improvement to drive operational excellence.
Overview
3
3
Languages
1
1
Certification
10
10
years of professional experience
Work History
Team Leader - HCC
Carecode Pro Info Tech Private Limited ( Clarus )
Coimbatore, India
08.2025 - Current
- Led a team of 18 HCC coders, delivering 98.6% coding accuracy with strict adherence to CMS-HCC guidelines, and achieving 100% productivity targets for risk adjustment projects.
- Conducted weekly quality audits (minimum 120 charts/reviewer/month), identifying trends and implementing corrective actions that improved overall quality scores by 22%.
- Owned client communication and escalation handling, resolving 95% of issues within SLA, and contributing to a 97% client retention and satisfaction rate.
- Functioned at an Assistant Manager level by managing end-to-end RCM operations, reducing denial rates by 18%, and improving first-pass claim acceptance to 96%.
- Drove team performance through structured training, onboarding 10+ new hires, and increasing team productivity by 27% within 3 months.
- Collaborated with operations and compliance teams to implement process improvements and automation initiatives, reducing turnaround time (TAT) by 15%.
- Prepared and presented reports, KPI dashboards, and variance analyses to senior leadership, enabling data-driven operational decisions.
Senior Executive - Coding Services
Corrohealth Infotech Private Limited
Coimbatore, India
04.2024 - 08.2025
- Worked on more than eight client projects in the HCC coding domain under the Medicare Advantage and ACA risk adjustment programs.
- Reviewed and abstracted medical records to assign accurate ICD-10-CM codes based on documentation, adhering to CMS HCC coding guidelines.
- Performed quality reviews and audits for peers to ensure compliance with internal and external coding standards.
- Generate daily and weekly productivity and quality reports to support performance monitoring.
- Contribute to process improvement initiatives, and client-specific documentation feedback.
- Prepare and share daily and weekly quality insights with the team to maintain high coding standards.
- Collaborate with QA and audit teams for continuous improvement in quality metrics.
- Assist in RCA (Root Cause Analysis) and CAP (Corrective Action Plan) documentation for client escalations.
Group Co-Ordinator
BillMed Healthcare Pvt Ltd
Coimbatore, India
11.2019 - 08.2023
- Supervised a team of 20 members, ensuring quality targets consistently met or exceeded standard requirements.
- Compiled and delivered detailed reports to stakeholders, facilitating informed decision-making.
- Facilitated and led weekly business calls to maintain communication and align team goals.
- Identified and eliminated barriers faced by the team during coding procedures, improving workflow efficiency.
- Collaborated with cross-functional teams to address denials and rejections, providing constructive feedback and solutions.
- Developed tailored reports customized to business requirements for enhanced performance tracking.
- Created a comprehensive process map for new software implementation, covering coding and billing functionalities.
- Effectively communicated client instructions and updates to the team to ensure compliance and accuracy.
Medical Coder - Quality Analyst
Sharp Info solutions Pvt Ltd
Coimbatore
03.2018 - 10.2019
- Oversaw quality improvement initiatives for a team of 15 members, ensuring strict adherence to accuracy standards and driving performance excellence.
- Expertly coded medical records following prescribed coding methods and procedures, including CPT, HCPCS, ICD-10-CM, and ASA codes.
- Collaborated with physicians and other stakeholders to clarify clinical documentation and ensure accurate code assignment.
- Provided training and guidance to staff on medical coding, billing procedures, and best practices to maintain compliance and improve quality.
- Ensured full compliance with medical coding policies, guidelines, and regulatory standards.
- Prepared and maintained patient charts by accurately documenting information in various company software systems.
- Managed the logging of all medical records requests using spreadsheets and tracking tools to ensure timely processing.
- Applied payments, adjustments, and denials accurately into the medical management system, supporting effective revenue cycle management.
Senior Officer
Janalakshmi Financial Services Pvt Ltd
Tiruchengode
08.2016 - 10.2017
- Evaluated and analyzed research and data from both internal and external sources to support the development of informed, strategic policy decisions.
- Increased revenue by conducting market evaluations and identifying new business opportunities and client prospects.
- Responsible for driving new product sales within the existing client base, enhancing client engagement and service value.
- Led a team of four members, overseeing daily operations, task delegation, and performance monitoring to ensure goal alignment and efficiency.
Education
B.E (Electronics and Instrumentation engineering) -
Hindusthan college of engineering and technology
Coimbatore04-2016
Diploma in Information Technology -
Sri Balakrishna Polytechnic college
Salem04-2012
Skills
- ICD-10, CPT, HCC, E/M, Anesthesia
- Continuous improvement
- Microsoft Excel, Word, and PowerPoint
- Effective communication
- Time management and reviewing performance
- Decision-making
- Problem Solving
- Strategic Planning
- Inventory tracking
- CMS and HHS HCC models
- Adherence to HIPAA and Compliance Standards
- HCC Risk Adjustment Coding
Certification
- Certified Coding Specialist (CCS)
- AI in Medical Billing and Coding
Accomplishments
Shining Start Award (09/2021)
Best Lead Topper Award (06/2022)
Best Lead Topper Award (03/2023)
As Group Coordinator, successfully led the team to consistently achieve 98–100% quality scores and exceed production targets, ensuring timely and compliant deliverables aligned with client standards.
As a Team Leader, Successfully transitioned 18 entry-level medical coders into the Auditing Team by identifying high-potential candidates, providing structured training, mentoring, and performance evaluation, ensuring a smooth transition and improved audit quality.
Languages
Tamil
First Language
English
Proficient
C2
Kannada
Proficient
C2
Hobbies and Interests
- Culinary activities
- Singing
Timeline
Team Leader - HCC
Carecode Pro Info Tech Private Limited ( Clarus )
08.2025 - Current
Senior Executive - Coding Services
Corrohealth Infotech Private Limited
04.2024 - 08.2025
Group Co-Ordinator
BillMed Healthcare Pvt Ltd
11.2019 - 08.2023
Medical Coder - Quality Analyst
Sharp Info solutions Pvt Ltd
03.2018 - 10.2019
Senior Officer
Janalakshmi Financial Services Pvt Ltd
08.2016 - 10.2017
B.E (Electronics and Instrumentation engineering) -
Hindusthan college of engineering and technology
Diploma in Information Technology -
Sri Balakrishna Polytechnic college