Vaitheeswaran Purushothaman.
Chennai
Summary
Experienced Surgery and IVR Auditor with 15 years of experience in Medical Coding Industry. Excellent reputation for resolving problems and improving customer satisfaction. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Senior Auditor - L2 - Medical Coding
Miramed Ajuba Solutions Private Ltd.
12.2013 - 11.2023
- Reviewed Surgery and IVR records and interpreted documentation to identify diagnoses and procedures.
- Reviewed Complex Scenarios in Surgery and IVR and Provided appropriate Coding without denials.
- In-depth knowledge of CPT and ICD-10 coding principles, government regulation, protocols and third party requirements
- Applied official General Coding Guidelines from American Medical Association (CPT Assistants), American Hospital Association (HCPCS Coding Clinics) and Centers for Medicare and Medicaid Services (NCCI Policy Manuals, MLN letters) to assign CPT and diagnostic codes.
- Tutored new coders and fellow auditors for Surgery and IVR and conducted calibration meetings to discuss and educate the complex surgery scenarios.
- Utilized active listening, interpersonal and telephone etiquette skills when communicating with others.
- Gained extensive knowledge in Surgery and IVR Coding, analysis and reporting
- Developed strong communication and organizational skills through working on group projects
- Provided professional services and support in dynamic work environment
- Adaptable and proficient in learning new concepts quickly and efficiently
- Proven ability to learn quickly and adapt to new situations
- Skilled at working independently and collaboratively in team environment
- Assisted with day-to-day operations, working efficiently and productively with all team members
- Learned and adapted quickly to new technology and software applications
- Self-motivated, with strong sense of personal responsibility
- Received Super Star Award in 2016 for Best Performance in Team.
Senior Medical Coder
Omega Healthcare Management Services Pvt. Ltd.
06.2012 - 12.2013
- Worked as Multi-Specialty Coding-Denial Management Coder.
- Identified root cause of denied claims to provide plans for denial resolution.
- Utilized Internet and other resources to research insurance policies for denied procedures and failed medical necessities.
- Maintained knowledge of insurance coverage benefit levels, eligibility systems and verification processes.
- Reviewed CMS's National and Local Coverage determinations to clear ICD denials.
- Reviewed chart documentation to support ICD-10 and CPT codes and took action if documentation was not coded appropriately.
- Examined medical treatment records and medical bills to gauge overall extent of liability.
- Correctly coded and billed medical claims for various hospital and nursing facilities
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures
Senior Coder - Coding
e4e Healthcare Business Services Pvt. Ltd.
11.2011 - 06.2012
- Worked as HCC Coder.
- Reviewed outpatient records and interpreted documentation to identify HCC diagnoses.
Medical Coding Executive
Dell International Services India Pvt. Ltd.
05.2008 - 07.2011
- Worked as Ancillary Coder.
- Reviewed outpatient records and interpreted documentation to identify valid diagnosis.
Education
Bachelor of Physiotherapy - Paramedical Sciences
AMS College of Paramedical Sciences.
Chennai, Tamilnadu, India05.2008
Skills
- CPC, CIRCC, CPMA Certified
- Surgery and IVR Coding
- ICD-10-CM and PCS
- Self-Motivated
- Decision-Making
- Flexible and Adaptable
- Written Communication
- Interpersonal Communication
- Organization and Time Management
- Active Listening
- Analytical and Critical Thinking
Certification
CPC (Certified Professional Coder), CIRCC (Certified Interventional Radiology Cardiovascular Coder), CPMA (Certified Professional Medical Auditor) Certified.
Languages
Tamil
Telugu
Hindi
English
Timeline
Senior Auditor - L2 - Medical Coding
Miramed Ajuba Solutions Private Ltd.
12.2013 - 11.2023
Senior Medical Coder
Omega Healthcare Management Services Pvt. Ltd.
06.2012 - 12.2013
Senior Coder - Coding
e4e Healthcare Business Services Pvt. Ltd.
11.2011 - 06.2012
Medical Coding Executive
Dell International Services India Pvt. Ltd.
05.2008 - 07.2011
Bachelor of Physiotherapy - Paramedical Sciences
AMS College of Paramedical Sciences.
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