Roby Mathew

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.

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

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)