Vineesh V
Assistant manager-Risk adjustment coding
Bangalore
Summary
Accomplished Assistant Manager at Agilon Health, adept in coding error resolution and fostering teamwork, significantly enhanced business growth and customer satisfaction. Excelled in records review and written communication, mentoring teams for optimal performance. Achieved high productivity and accuracy rates, leveraging skills in medical coding and strategic planning for continuous improvement.
Overview
8
8
years of professional experience
4
4
years of post-secondary education
3
3
Certifications
Work History
Assistant Manager
Agilon Health
08.2023 - Current
- Promoted teamwork within the workplace by encouraging collaboration among staff members on various projectstasks.
- Tracked and monitored requests for medical records release.
- Collaborated with the management team to develop strategic plans for business growth and improvement.
- Optimized workloads by analyzing staffing needs, reallocating assignments accordingly based on individual strengths and areas of expertise.
- Established strong working relationships with external partners, including insurance carriers and third-party administrators, to streamline claims processing and enhance overall customer satisfaction.
- Mentored new hires in medical coding processes, resulting in a more cohesive and effective team dynamic.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Monitored changes in coding regulations to provide recommendations for compliance.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
Risk Adjustment Coder
Agilon Health
12.2022 - 07.2023
- Mitigated potential financial loss due to improper code assignments by staying informed on payer-specific requirements and trends in risk adjustment methodology.
- Supported the onboarding of new team members by providing mentorship and guidance as they learned the intricacies of risk adjustment coding.
- Demonstrated flexibility and adaptability in response to changes in coding guidelines, software systems, or departmental priorities.
- Reduced coding errors through rigorous attention to detail, thorough knowledge of ICD-10-CM guidelines, and continuous professional development.
- Achieved high levels of coder productivity by consistently meeting or exceeding established benchmarks for daily coding volume and accuracy rates.
Senior Medical Coder
Optum Healthcare company
9 2020 - 04.2022
- Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
- Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
- Used Optum 360 to assign procedure and diagnostic codes to patient records for billing purposes.
- Reviewed patient charts to better understand health histories, diagnoses and treatments.
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Entered orders into EMR system efficiently and without errors.
Quality Control Analyst
omega healthcare pvt ltd
07.2016 - 08.2020
- Reviewed outpatient records and interpreted documentation to identify all diagnoses and procedures.
- Guarded against fraud and abuse by verifying all coded data accurately reflected services provided.
- Reviewed 40-50 medical records per day to select appropriate coding sequences.
- Verified signatures and checked medical charts for accuracy and completion.
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Coded inpatient charts at rate of 3-4 per hour .
- Reviewed patient charts to better understand health histories, diagnoses and treatments.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Compiled, abstracted and coded patient data using classification manuals and standard systems.
- Maintained accuracy, completeness and security for medical records and health information.
- Identified new methods to optimize medical records management.
- Processed patient admission and discharge documentation.
- Developed and audited practices, programs and reporting system metrics for optimal efficiency.
- Trained and coached existing and new employees on multiple investigative case types and internal control processes.
- Planned and implemented performance improvement and quality assurance programs.
- Participated in weekly meetings with Training department.
Education
Executive Post-Graduate Programme in Healthcare - Healthcare Management
Loyola Institute of Business Administration
Chennai 03.2021 - 02.2022
Bachelor of Science - Microbiology
Sri Vidyanikethan Degree College
A. Rangampet Tirupati 06.2011 - 05.2014
Skills
ICD-10 Proficiency
Team Management
HIPAA Compliance
Clinical Documentation
Training and mentoring
Coding Error Resolution
Languages
English
Very Good
Telugu
Excellent
Certification
LEAN SIX SIGMA GREEN BELT
Interests
Gaming
Traveling
Accomplishments
- Proven track record of managing concurrent and retro projects and processes
- Supervised team of 25 staff members.(global & US)
- Achieved 100% quality in 6 Client Audits by completing Common Ground Healthcare Cooperative project with accuracy and efficiency.
Timeline
Assistant Manager
Agilon Health
08.2023 - Current
CRC -certified risk adjustment coder
07-2023
Risk Adjustment Coder
Agilon Health
12.2022 - 07.2023
Executive Post-Graduate Programme in Healthcare - Healthcare Management
Loyola Institute of Business Administration
03.2021 - 02.2022
LEAN SIX SIGMA GREEN BELT
01-2020
CPC - Certified Professional Coder
05-2018
Quality Control Analyst
omega healthcare pvt ltd
07.2016 - 08.2020
Bachelor of Science - Microbiology
Sri Vidyanikethan Degree College
06.2011 - 05.2014
Senior Medical Coder
Optum Healthcare company
9 2020 - 04.2022
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