Nirmala Eri

Medical Coding professional with 15 years of coding experience, including 10 years of UAE experience in inpatient and emergency department coding. Currently/most recently served as a Specialist Inpatient Medical Coder at Al Qassimi Hospital, Sharjah. Certified CPC and CIC through AAPC and CCS through AHIMA, with strong experience in ICD-10-CM, CPT, HCPCS, IP-DRG, emergency/outpatient coding, HCC risk adjustment, clinical documentation review, physician queries, cost estimation, claims processing, and RCM workflows.

Experienced with EHS and DHA coding guidelines, 3M Coding and Reimbursement System, HDM, Encoder Pro, and Medical Coder Expert.

Specialist Inpatient Medical Coder – Inpatient & Emergency Departments - Al Qassimi Hospital, Sharjah - Sharjah, UAE

(2016-03 - 2026-07)

Worked under a 3M contract from March 2016 to April 2024; worked with Fatorah Insurance and Management Pvt. LLC from May 2024 to July 2026.

• Performed inpatient medical coding in accordance with EHS coding guidelines and hospital compliance standards.
• Assigned accurate ICD-10-CM and CPT codes based on coding guidelines and IP-DRG requirements.
• Reviewed clinical documentation, discharge summaries, operative notes, and physician records to support accurate code assignment.
• Used Health Data Management (HDM) tools and the 3M Coding & Reimbursement System for coding and DRG assignment.
• Maintained mandatory coding accuracy of 95% and above while meeting productivity and turnaround-time targets.
• Performed inpatient and self-pay coding in accordance with DHA and EHS coding guidelines.
• Applied CPT, HCPCS, medication, physician service, bed charge, operative, anesthesia, dietician, physiotherapy, infusion, injection, radiology, and related procedure codes.
• Escalated documentation queries to physicians for incomplete or clinically unsupported documentation and supported accurate, specific ICD-10 code assignment.
• Educated physicians on clinical documentation improvement practices based on EHS guidelines, JCI standards, and ICD-10 coding requirements.
• Prepared and maintained monthly physician query reports and collaborated with physicians, coders, and clinical teams to improve documentation quality and reimbursement accuracy.
• Prepared cost estimation reports and coordinated with physicians, billing teams, and clinical departments for accurate charge capture.
• Performed outpatient and emergency coding across multiple clinical departments using EHS and DHA coding guidelines.
• Processed an average of 170 emergency department claims per day and approximately 200 outpatient claims daily while meeting productivity and turnaround-time targets.
• Maintained coding accuracy of 98% and above during internal quality audits.

Domain Expert – Medical Coding - United Health Group - Hyderabad, India

(2013-05 - 2016-02)

• Performed outpatient and emergency department coding by reviewing medical records and abstracting accurate clinical information.
• Assigned ICD-9-CM, ICD-10-CM, CPT-4, and HCPCS codes based on physician documentation and coding guidelines.
• Maintained HIPAA compliance and confidentiality of protected health information.
• Performed HCC coding for risk adjustment and documentation support.
• Coordinated with team leads regarding coding guideline updates, regulatory changes, and workflow improvements.
• Supported development and implementation of productivity, quality, and coding accuracy metrics.

Senior Process Executive – Data - Cognizant Technology Solutions - Hyderabad, India

(2010-12 - 2013-01)

• Performed emergency department coding using ICD-10-CM and HCPCS Level II codes based on clinical documentation.
• Processed an average of 140–150 claims daily while meeting productivity and turnaround-time targets.
• Maintained 98% monthly coding accuracy through adherence to coding standards and quality practices.
• Assigned E/M and CPT codes with appropriate modifiers based on medical documentation and payer requirements.
• Verified insurance coverage and applied payer-specific coding rules to support accurate billing.
• Participated in coding quality audits and implemented feedback to improve accuracy and compliance.

Coding Officer - PI-International Pvt. Ltd.

(2009-09 - 2010-09)

• Performed HCC coding based on clinical documentation and coding guidelines.
• Reviewed chronic conditions and supporting clinical evidence before assigning risk-adjustment diagnoses.
• Assigned ICD-10-CM diagnosis codes according to documented medical conditions and HCC requirements.
• Reviewed and recoded denied medical records within required turnaround times to support claim resubmission and reimbursement accuracy.

Duty Medical Officer / Junior Doctor - Swapna Health Care

(2008-06 - 2009-09)

• Provided duty medical officer services and applied clinical knowledge that supports medical terminology, documentation, and healthcare coding.

Bachelor of Homoeopathic Medicine & Surgery - B.H.M.S - Government Homoeo Medical College, Kadapa, N.T.R University, Vijayawada (2002 - 2008)

B.Sc. - B.Z.C - Jawahar Bharathi Degree College, Kavali, Nellore (1998 - 2002)