SIVA KIRAN CH
Summary
Results-oriented medical coding assistant manager with over 11 years of experience in managing computerized encoding and overseeing billing functions. Proficient in CPT, ICD, LCDs, NCCI edits, and payer-specific requirements. Skilled in multi-specialty RCM, including Denial coding, ED, Radiology, and Pathology coding in outpatient settings.
Overview
12
12
years of professional experience
5
5
years of post-secondary education
2
2
Certifications
Work History
Assistant Manager
AGS Health Pvt Ltd
10.2023 - Current
- Responsible for the daily operations in team including monitoring work and quantity of workflow to ensure completion of work assignments
- Troubleshooting and problem-solving skills, Have strong knowledge in end-to-end RCM
- Ability to manage multiple clients, projects, tasks and expectations simultaneously
- Experience in Physician Coding (Multi specialty denial, Radiology, Pathology, EM)
- Identifying denial trends and sharing the prevention plans to internal leadership team and clients
- Ability to ensure client satisfaction through follow-up, customer responsiveness and thorough communication
- Strong internal communication skills including the ability to work with next levels and other teams of the organization
- Sound knowledge in MS Office – Excel, PowerPoint, Word, planning resources, staffing, B2A
- Responsible for detecting potential issues and implementing solutions when issues threaten to delay the timeline or impact on business operations
- Responsible for providing senior leadership team with updated implementation plans, which may include project schedules, project plans, benchmark metrics, communications documents, follow-up memos, etc
- Work closely with the Transition and Operations Team to ensure appropriate follow-up of identifying client needs and follow-up activities
- Hosting online meetings and conference calls to present new functionality, perform training, and collaborate with team about concerns
- Following Client Standard Operating Procedure (SOP) instructions for all ongoing business and transitioning the project to the Operations team
- Leading successful new business onboarding implementations, communication campaigns, meeting timelines
- Performs half yearly and annual performance evaluations to leaders.
Supervisor
AGS Health Pvt Ltd
04.2022 - 09.2023
- Work closely with the resources responsible for delivery of related work streams within the programs
- Monitors employee performance against established performance metrics Provides, sharing bi-weekly reports to client and the internal Stakeholders
- Performs half yearly and annual performance evaluations on staff
- Assist in handling all employee problems & disputes, and continually strive to develop the staff in all areas of managerial and professional development
- Conducting regular team huddles to get inputs from team for better results
- Documenting and sharing MOM’s with team and next level leaders
- Having one on ones with employees and addressing team challenges
- Assist to provide necessary information and ad-hoc assignments to allow for accurate and timely submission of reports to stakeholders
- Develops staff through coaching, providing performance feedback, providing effective performance assessments to meet the standards
- Also, sharing the project updates through LMS to arrest the knowledge gaps
- Execute day-to-day administration of direct reports including leave management, workforce management etc
- Constant and regular review of processes and performance with focus on improving team competency/performance rating
- Assist in supervising production personnel
- Provide guidance, assistance and training to team members
- Assist in determining daily workflow
- Sharing effective communication to WFM team for resources as per client or business requirements
- Acting proactively and updating details with Managers for team success
- Will work together with internal team & other teams to assist with projects and initiatives as necessary to meet the needs of business
- Communicating with client on regular basis to share the progression of work.
Team Leader
AGS Health Pvt Ltd
01.2019 - 03.2022
- Responsible for clarifying and resolving coding-related queries raised by the internal billing team and the client
- Implement corrective and preventive actions resulting from rejections / denials.
Associate
IKS Health Pvt.Ltd
04.2014 - 08.2015
- Responsible for clarifying and resolving coding related denials and rejections
- Coding and auditing files as and when required and participating in internal audits under the guidance of coding supervisor
- Responsible for discussing audit findings and sharing denial trends with the clients/ internal team
- Maintain necessary records and reports.
Pharma Benefit Analyst
United Health Care (Optum Health)
03.2012 - 02.2013
- Work with Pharmacy Network Management to implement pharmacy rate changes and network additions in the pharmacy claim adjudication system
- Perform basic analysis using knowledge of simple business rules by interpreting data from various sources and formats and utilize the data for configuration activities
- Assist in and is accountable for identification, documentation, and escalation of risks, data errors and issues throughout the configuration process.
Education
B.Pharmacy -
St. Ann’s College of Pharmacy
01.2008 - 04.2010
+2- Bi.P.C - undefined
Uma Maheswari Junior College
01.2005 - 04.2007
Skills
Team Management
Handling multiple clients
CPT & ICD Coding
Time Management
Invoice Processing
Negotiation Skills
Microsoft Office
Audit Analysis – QIP, RCA, AP, CAPA
ESR Reports
Certification
Certified Profession Coder (CPC) approved by AAPC.
Disclaimer
I solemnly declare that all the information furnished in this document is true and accurate to the best of my knowledge.
Watching movies, spending time with family, surfing internet and exploring about new technologies
Viewing suspense thriller films, enjoying quality time with family, browsing the internet and delving into the latest technological advancements.
Timeline
Assistant Manager
AGS Health Pvt Ltd
10.2023 - Current
Supervisor
AGS Health Pvt Ltd
04.2022 - 09.2023
Team Leader
AGS Health Pvt Ltd
01.2019 - 03.2022
Associate
IKS Health Pvt.Ltd
04.2014 - 08.2015
Pharma Benefit Analyst
United Health Care (Optum Health)
03.2012 - 02.2013
B.Pharmacy -
St. Ann’s College of Pharmacy
01.2008 - 04.2010
+2- Bi.P.C - undefined
Uma Maheswari Junior College
01.2005 - 04.2007