Suganya Raghuveeran

Detail-oriented Senior Process Associate with 6.5+ Years of experience in US Healthcare Anesthesia Medical Billing. Expertise in CPT/DX Entry, Demographics, Charge Entry, Rejection Process & Denial Management. Proficient in Focus MD & Medisuite software. Strong knowledge of CO-45, CO-16, CO-29, CO-151, CO-97, CO-197 denial codes & Modifiers 25, 24, 59, 50, AA, QK, QX. Proven track record of maintaining 99% accuracy and reducing claim rejections.

Senior Process Associate - OMEGA HEALTHCARE

(2021-07)

• Last 6 Months | Denials Process - Handled Anesthesia denials - Worked on CO-45, CO-16, CO-29, CO-151, CO-97, CO-197 denial codes using Focus MD and resubmitted claims with required corrections
• 1 Year | Rejection Process - Managed Rejection Process - Reviewed claim rejections from Clearing House like Policy No Invalid, Insurance Invalid. Analyzed errors, corrected demographics & insurance details, and resubmitted claims
• First 1.5 Years | CPT/DX & Charge Entry Process - Performed Document Review for Anesthesia services - Used Focus MD for Demographics & Charge Entry. Calculated ASA base units + time units, applied Physical Status modifiers P1-P3 & Modifiers 25, 24, 59, 50, AA, QK, QX as per documentation

Senior Process Associate - ACCESS HEALTHCARE

(2019-07 - 2021-06)

• 2 Years | Demographics & Charge Entry Process - Performed Document Review for Anesthesia claims and completed Demographics & Charge Entry using Medisuite software. Applied Modifiers 25, 59 for distinct procedural services with high accuracy

Senior Process Associate - MIRAMED AJUBA

(2018-01 - 2019-06)

• 1.5 Years | Charge Entry Process - Performed Charge Entry for Anesthesia claims after document review. Verified CPT codes and applied Modifiers 25, 24, 50, 59 based on operative notes

Bachelor's Degree - Anna Adarsh College for Women (2015)