Vignesh Saminathan

• Gained in-depth knowledge of coding techniques and guidelines of medical coding then auditing the medical records (CPT, ICD, HCPCS) coded by team.

• Reviewing the superbill and patient medical records to assign the right CPT and ICD.

• Proactively involved in checking the quality of claims (Bundling CPTs and inappropriate modifier 25,51 and 59-Separate Procedure).

• Imparting knowledge & assistance to the team whenever deemed necessary, thus playing an important role in team building.

• Audit –Retrospective E/M audit was done for Medicare claims to determine whether over payment on claims have been made to physician practice for the facility using trailblazer audit tool.

• Denial Management –Resubmitted the claims either rejected from insurance or navicure (front office) by appropriate correction with detailed explanation as per the general coding guidelines and insurance specific rules.

• Assigning diagnostic and procedural codes to ER Medical records.

• Reviewing the E/M reports and assigning CPTs along with appropriate modifier for minor & major procedures • Proactively involved in checking the quality which are coded by other coders and educate them to maintain 98% of quality.

• Attended coding conferences, workshops, and in-house sessions to receive updated coding information and changes in coding and/or regulations.

• Knowledge of disease processes and procedural techniques to consistently apply the correct codes.

• Filed and updated patient information and medical records.
• Scheduling the appointments for physicians and verify the coverage and updating the pending payments for the established patients
• Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
• Researched CPT and ICD-10 coding discrepancies for compliance and reimbursement accuracy.
• Liaised between patients, insurance companies, and billing office.
• Collected payments from insurance and applied to patient accounts.
• Communicated with insurance providers to resolve denied claims and resubmitted.
• Posted and adjusted payments from insurance companies.
• Located errors and promptly refiled rejected claims.
• Communicated with patients for unpaid claims for HMO, PPO and private accounts and delivered friendly follow-up calls for proper payments to contracts.