Sonali Kolte
Mumbai
Summary
Medical coding professional with over 5 years of experience in HCC coding and clinical data management. Developed a comprehensive training module at Optum, resulting in increased employee productivity. Recipient of the Kulapati Award at Bhavans College for outstanding contributions. Seeking to leverage coding and training expertise in an HCC / Risk Adjustment Coder role to enhance healthcare outcomes.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Training Specialist-Medical coding
Optum
Mumbai
06.2020 - Current
- Increased employee productivity by designing, developing, and implementing a comprehensive training module that addressed critical skill gaps and enhanced workforce capabilities.
- Conducted engaging training programs and workshops, tailored to various departmental needs, resulting in improved employee performance and efficiency.
- Monitored the effectiveness of training through participant feedback and performance assessments, making data-driven adjustments to continuously improve training outcomes.
- Fostered a collaborative learning environment, promoting knowledge sharing and skill development across the organization.
- Conducted thorough reviews of medical records to accurately assign Hierarchical Condition Categories (HCCs) and other risk-adjusted codes, ensuring compliance with CMS guidelines and payer requirements.
- Performed detailed chart reviews to assess documentation completeness and identify all relevant codes for proper reimbursement and risk adjustment.
- Monitored adherence to strict compliance standards, including HIPAA regulations, and internal organizational policies to maintain data security and confidentiality.
- Stayed abreast of the latest coding guidelines, payer regulations, and CMS policy updates, ensuring continuous accuracy and compliance.
- Actively participated in process improvement initiatives to enhance coding accuracy, efficiency, and workflow within the department.
- A health service and technology company.
- Led the end-to-end design, build, and configuration of healthcare applications as the primary point of contact, ensuring alignment with business and clinical requirements through continuous collaboration with cross-functional teams. Acted as a subject matter expert in Electronic Medical Records (EMR), driving key architectural and functional decisions, and translating user requirements into clear technical specifications. Managed and mentored the application team, taking ownership of team decisions, resolving complex issues, and facilitating training sessions to enhance capability, productivity, and quality of deliverables. Oversaw system integration and data migration activities, monitored project progress against milestones, and implemented course corrections to meet timelines, while ensuring adherence to healthcare regulatory and compliance standards.
Lab Assistant
Ismail Yusuf College
Mumbai
06.2019 - 06.2020
- Worked as a Lab Assistant in the biotechnology lab, supporting faculty and students with practical experiments and research activities.
- Maintained laboratory equipment and managed inventory to ensure the availability and functionality of essential tools and supplies.
- Assisted in daily laboratory operations, preparing materials and conducting experiments to support academic curriculum and research goals.
- Conducted interactive sessions for final-year students, guiding them through complex laboratory techniques, fostering hands-on learning, and enhancing their understanding of biotechnology concepts.
- Ensured adherence to safety standards and best practices in the laboratory environment.
- An academic institution focused on higher education and research.
Internship
Veena Nursing Home
04.2019 - 05.2019
- Provided direct assistance in a clinical setting, supporting healthcare professionals with patient care and administrative tasks.
- Gained hands-on experience in performing clinical procedures, handling medical equipment, and assisting in patient assessments.
- Assisted in the preparation of patient records, ensuring accurate documentation and maintaining confidentiality in compliance with HIPAA regulations.
- Worked alongside medical staff to ensure smooth daily operations and contributed to enhancing patient care quality.
- Demonstrated strong communication skills by interacting with patients and staff, providing support in a fast-paced environment.
Internship
ICMR-NIRRCH
Mumbai
01.2017 - 06.2017
- Gained hands-on training in various lab-based techniques, including molecular biology methods, microscopy, and data analysis, to support biotechnology research and experiments.
- Assisted in the preparation and execution of laboratory experiments, ensuring accurate collection and analysis of data to support research objectives.
- Worked on projects involving advanced lab techniques, enhancing the understanding of molecular processes and contributing to the success of research initiatives.
- Maintained and calibrated laboratory equipment, ensuring proper functionality and a safe, efficient working environment.
- Collaborated with faculty and students, providing technical support and guidance during experiments and practical sessions.
Education
Masters of Science - Biotechnology
Ramniranjan Jhunjhunwala College
Mumbai08.2017
Bachelors of Science - Biotechnology
Bhavans College
Andheri (West)04.2015
Higher Secondary Certificate -
Sathaye College
Maharashtra04.2012
Secondary School Certificate -
Cambridge School
Mumbai03.2010
Skills
- Molecular biology techniques
- Electrophoresis
- Western blotting
- Histological techniques
- Paraffin embedding
- Sectioning
- Immunohistochemistry – IHC
- Coding HCC
- ICD 10 CM
- CPC
- Office suite
- Word
- PowerPoint
- Excel
- SharePoint
- Compliance monitoring
- Employee training
- Process improvement
- Team collaboration
- Effective communication
- Video instruction
- Training delivery
- Blended learning
- Training material design
- Feedback collection
- Medical coding
- Designing training programs
- HCC assignment
- Data analysis
- Quantitative assessment
Certification
- Emergency Medical Technician
- Medical Coding training
- Clinical Data Management
- AHIMA Certification
- CPC Certification
Accomplishments
- First Rank in Science Exhibition: Achieved first rank for the project 'Agriculture and Food Security' in a science exhibition in 2008-2009.
- Kulapati Award: Received the Kulapati Award at Bhavans College in 2014-15.
Projects
NaamCa, Ensured accurate coding and compliance with CMS guidelines for risk-adjusted populations in the project. Wellcare MRA, Supported Wellcare's MRA initiative by accurately coding medical records to capture relevant Hierarchical Condition Categories (HCCs). Village MD & Concurrent, Conducted coding reviews for Village MD & Concurrent, enhancing documentation and ensuring proper reimbursement for risk-adjusted populations. Aetna MRA, Focused on accurate coding for Aetna MRA, ensuring compliance with CMS regulations and improving risk adjustment outcomes. BCID, Managed medical coding for BCID, contributing to risk-adjusted coding and ensuring adherence to payer guidelines. EMBLEM, Delivered coding support for EMBLEM, ensuring that clinical data was accurately captured and aligned with regulatory standards. HCSC Pilot, Contributed to the HCSC pilot project by coding medical records and ensuring compliance with risk adjustment protocols and payer guidelines.
Passions
- Dancing and Music: Enjoy dancing and listening to music in my free time.
- Enjoy exploring new things.
Languages
Marathi
Native language
English
Upper Intermediate (B2)
B2
French
Elementary (A2)
A2
Hindi
Upper Intermediate (B2)
B2
Timeline
Training Specialist-Medical coding
Optum
06.2020 - Current
Lab Assistant
Ismail Yusuf College
06.2019 - 06.2020
Internship
Veena Nursing Home
04.2019 - 05.2019
Internship
ICMR-NIRRCH
01.2017 - 06.2017
Masters of Science - Biotechnology
Ramniranjan Jhunjhunwala College
Bachelors of Science - Biotechnology
Bhavans College
Higher Secondary Certificate -
Sathaye College
Secondary School Certificate -
Cambridge School