Roby Mathew
Certified Professional Coder (CPC-AAPC)
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About
Seeks to achieve a position as a Medical Auditor or related to the profession that would allow utilizing certification, experience, education, and knowledge that have acquired.
Experience
Senior Executive - HCC Auditor - NPB Consultants Pvt Ltd - New Delhi, India
(2023-04)
- Performed daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical background to ensure appropriateness for reimbursement
- Review and accurately coded medical records for diagnosis related to Risk adjustments and HCC coding guidelines
- Conducts chart audits to identify incorrect coding and errors
- Prepare reports of findings following official coding guidelines including AHA Coding clinic
- Maintaining 96% accuracy
- Meeting production goals as outlined by management
HCC Coder / HCC Auditor - Optum Health & Technology (India) Private Limited - Chennai, India
(2021-06 - 2023-03)
- Performed daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical background to ensure appropriateness for reimbursement
- Ensured all diagnoses and services are accurate and complete from the patient encounter in accordance with the ICD-10-CM Official Guidelines for Coding and Reporting
- Maintained 96% accuracy
- Reviewed assigned medical records daily to capture all appropriate and accurate diagnosis in compliance with CMS and HCC categories and guidelines for ICD-10 coding
- Reviewed lab and consult reports for identifying documented diagnosis. Review medication list to verify if there is a correlating condition and if conditions are still being treated
- Provided clear communication through query to Physician on documentation not meeting standard of basic administrative components to an encounter progress note
- Worked as part of a team and achieve the team quality and productivity standards
Medical Recs Coding & Transc. Senior Rep - NTT DATA Business Solutions Private Limited - Chennai, India
(2021-02 - 2021-06)
Radiology coder
- Accurately entered procedure codes, diagnosis codes and patient information to billing software
- Determined diagnosis codes for accuracy, completeness & specificity according to the service rendered
- Strong knowledge of CPT and ICD-10 guidelines
Senior Physiotherapist - Grace Multi-Specialty Hospital - Tamil Nadu, India
(2007-11 - 2011-01)
Physiotherapist - Quality Care Physiotherapy Center - Kochi, Kerala
(2016-10 - 2017-10)
Medical Writer - Freelance
(2013-06 - 2014-06)
Worked as freelance medical writer and web researcher
Education
Certified Professional Coder (CPC) - Medical Coding - Cigma Medical coding Academy (2020-09 - 2021-01)
Bachelor Of Physiotherapy - Physiotherapy - Dr. MGR Medical University (2002 - 2007)
Higher Secondary Course - Department of Tamil Nadu Govt. Examination (2002-03)
Matriculation Examination - Department of Tamil Nadu Govt. Examination (2000-03)
