shainy biju
Medical Coder
Trivandrum
Summary
Accomplished Medical Coder with a proven track record at Guidehouse, enhancing coding accuracy and reducing claim denials through meticulous documentation review and effective communication. Proficient in ICD-10 coding and HIPAA compliance, I excel in team collaboration and continuous improvement, driving revenue cycle performance and ensuring adherence to regulatory guidelines.
Overview
2026
2026
years of professional experience
3
3
Certifications
Work History
Medical Coder
Guidehouse
2024 - Current
- 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.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Promoted teamwork within the department through effective communication and collaboration on complex cases.
- Ensured compliance with industry regulations and guidelines by staying up-to-date on the latest coding changes.
- Verified signatures and checked medical charts for accuracy and completion.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Enhanced team efficiency with regular training sessions on new coding updates and best practices.
- Supported the implementation of electronic health record systems, simplifying the coding process.
- Trained and mentored junior coders to support growth and development amd apply high-quality coding practices.
- Utilized active listening, interpersonal, and telephone etiquette skills when communicating with others.
- Reduced claim denials by maintaining thorough knowledge of payer-specific requirements and guidelines.
- Collaborated with physicians to obtain necessary documentation, improving claim approval rates.
- Minimized errors by providing ongoing feedback to clinical staff regarding proper documentation practices.
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Generated reports to identify coding trends and discrepancies.
- Streamlined patient data entry into coding software, optimizing billing cycle and improving cash flow.
- Played key role in transition to ICD-10 coding system, leading training sessions and updating coding protocols.
- Maintained up-to-date knowledge of coding guidelines and regulations, ensuring compliance across all coding activities.
- Streamlined billing process, ensuring compliance with healthcare regulations through diligent code assignment.
- Conducted comprehensive training sessions for new coders, enhancing team proficiency and coding accuracy.
- Improved patient privacy protection by strictly adhering to HIPAA regulations during coding and billing process.
- Ensured accuracy in high-volume coding environments, applying codes for over 200 patient records weekly without compromising detail or compliance.
- Kept coding team informed of changes in coding standards and healthcare regulations through monthly newsletters.
- Verified accuracy of patient information in medical records.
- Maintained accuracy, completeness, and security for medical records and health information.
- Researched and resolved medical record discrepancies.
Medical Coder
Medvance
2023 - 2023.11
- Reduced turnaround time for appeals by preparing comprehensive supporting documentation for denied claims.
- Prevented costly fines by ensuring adherence to HIPAA regulations when handling sensitive patient information.
- Conducted internal audits to identify areas for improvement in coding accuracy and compliance.
- Enhanced revenue cycle performance by identifying and correcting under-coded claims, ensuring maximum reimbursement for services rendered.
- Enhanced coding accuracy by meticulously reviewing patient records and applying correct medical codes.
- Boosted coding department efficiency, implementing new electronic health record system for easier access to patient information.
- Enhanced team collaboration, organizing regular meetings to discuss coding challenges and share best practices.
- Improved reimbursement rates with accurate and timely submission of medical codes for various treatments and diagnoses.
- Reviewed medical records for completeness and filed records in alphabetic and numeric order.
- Used classification manuals to gain additional knowledge of disease and diagnoses processes.
- Followed exact procedures for handling transfers and other releases of medical records.
- Tracked and monitored requests for medical records release.
- Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
- Correctly coded and billed medical claims for various hospital and nursing facilities.
- Verified signatures and checked medical charts for accuracy and completion.
- Ensured compliance with industry regulations and guidelines by staying up-to-date on the latest coding changes.
Assistant Process Associate
Seha Global
2021 - 2021.07
- Collaborated with team members to complete projects on time and within budget constraints.
- Utilized advanced analytical skills to identify trends and patterns in data, informing future process improvements.
- Enhanced communication between departments by creating informative reports and presenting findings at team meetings.
- Ensured accurate data entry through consistent review of inputted information, reducing occurrences of discrepancies or errors significantly over time.
- Assisted in the implementation of new software tools, resulting in increased productivity and reduced errors.
- Improved process efficiency by streamlining workflows and identifying areas for improvement.
- Developed strong working relationships with cross-functional teams, fostering a collaborative work environment.
- Maintained strict confidentiality regarding sensitive information, adhering to company policies and procedures at all times.
- Maintained accurate records of all work completed, ensuring timely completion of tasks and adherence to company standards.
- Identified modifications to processes and procedures that would promote better efficiency.
- Collected, arranged, and input information into database system.
- Generated reports detailing findings and recommendations.
- Maintained database systems to track and analyze operational data.
Education
B.Tech - Biotechnology
Udaya School of Engineering
Kanyakumari, Tamilnadu 05.2006
Higher Secondary - Science
Sarada Vilasam Higher Secondary School
Attingal04.2006
SSLC -
Navbharat English Medium High School
Attingal 04.2004
Skills
Medical terminology
Coding error resolution
HIPAA compliance
Clinical documentation
Diagnostic coding
Inpatient records coding
Knowledgeable in software
Data verification
Insurance verification
Proficiency in software
Data entry
Medical record security
Performance improvement
Workflow management
Medical classification systems
Patient data compilation
Documentation oversight
Medical software proficiency
Records management
Claims processing
Regulatory guidelines
Data security procedures
Training and mentoring
Insurance claims analysis
Certification maintenance
Record assessment
Anatomy
Healthcare claim coding
Data entry and management
Error reporting
Coding appeals
Medicare insurance regulations
Ethical standards
Patient data identification
ICD-10 coding
Time management
Microsoft Excel
Certified medical coder
Teamwork and collaboration
Problem-solving abilities
Certified professional coder (CPC)
Multitasking
Interpersonal skills
Effective communication
Excellent communication
Adaptability and flexibility
Continuous improvement
EMR systems
Discharge documentation
Certified professional coder
Attention to detail
Analytical thinking
3M encoder
Problem-solving
Interpersonal communication
Active listening
Records review
Team collaboration
Task prioritization
Self motivation
Problem-solving aptitude
Electronic health records
Patient medical records maintenance
Epic systems
Records accuracy
Health record index maintenance
Certification
CPC
Timeline
CPC
2022-10
Clinical research
2011-09
Internship training certificate
2011-08
Medical Coder
Guidehouse
2024 - Current
Medical Coder
Medvance
2023 - 2023.11
Assistant Process Associate
Seha Global
2021 - 2021.07
B.Tech - Biotechnology
Udaya School of Engineering
Higher Secondary - Science
Sarada Vilasam Higher Secondary School
SSLC -
Navbharat English Medium High School