Mounika Gaddam

Seeking a challenging and prospective career that helps contribute to the organization which will also provide me an opportunity to expand my learnings, knowledge, and skills as an individual.

Subject Matter Expert Charge Entry – Medical Billing - Unislink Health Care Private Limited

(2020-09 - 2026-02)

As a Subject Matter Expert with key responsibilities in medical billing and revenue cycle management.

• Perform accurate charge entry for Hospital (Facility) and Physician (Professional) billing.
• Review patient demographics, insurance details, and provider information before posting charges.
• Validate CPT, ICD-10-CM, and HCPCS codes as per payer and client guidelines.
• Ensure correct modifiers usage for physician billing.
• Process inpatient, outpatient, and emergency room charges.
• Maintain compliance with HIPAA regulations and US healthcare billing standards.
• Monitor daily productivity, quality metrics, and TAT adherence.
• Provide SME support, resolve complex billing issues, and handle escalations.
• Reduced charge entry rejection volume by identifying root causes and implementing corrective actions.
• Analyzed billing rejections and coordinated with teams to improve first-pass acceptance rates.
• Successfully reduced claim rejections through accurate charge entry and adherence to payer guidelines.
• Proactively reviewed rejection trends and provided process recommendations, resulting in improved billing quality.
• Coordinate with Coding, AR, and Denial Management teams to ensure smooth revenue cycle flow.
• Maintained 98–100% accuracy in charge entry for both hospital and physician accounts.
• Reduced billing errors through internal audits and corrective actions.
• Improved team productivity by streamlining workflows.
• Successfully handled high-volume claims within defined TAT.
• Recognized by management for process expertise and team leadership.

B. Pharmacy - Pharmacy - Sri Indu Institution of Pharmacy, Hyderabad (2019)

Intermediate - St. Pious X Junior College, Hyderabad (2014)

SSC - Jyothi Bala Mandir High School, Hyderabad (2012)