SME (EM OP/IP with minor surgery,ED Facility&professional for CDI) - REVENTICS PRIVATE LIMITED (AN OMEGA HEALTH CARE COMPANY) - HYDERABAD
(2025-07 - 2026-05)
- Provide expert guidance on medical coding standards, payer guidelines, and compliance requirements.
- Conduct coding audits( Prospective and Retrospective) to ensure accuracy and adherence to ICD10 CM,CPT,HCPCS guidelines. Develop training modules and mentor coding teams to improve productivity and reduce errors.
- Support new client transitions by reviewing project requirements, creating sops, and providing domain expertise.
- Collaborate with QA,operations, and billing teams to resolve coding related denials and optimize reimbursement.
- Monitor coding updates from CMS/AMA and implement changes in processes and training material.
Quality Analyst- (E/M OP and IP with Minor Surgery) - CORRO HEALTH INFOTECH PRIVATE LIMITED - HYDERABAD
(2025-02 - 2025-07)
- Perform quality audits on outpatient and inpatient and specialty coding to ensure compliance with ICD 10 CM ,CPT,HCPCS and payer guidelines.
- Review coded charts against clinical documentation to validate coding accuracy, sequencing, and medical necessity.
- Provide feedback and error trend analysis to coders, supporting corrective action plans.
- Develop and update audit tools, quality checklist, and SOPS aligned with CMS,AMA, and client requirements.
- Conduct RCA of recurring coding errors and recommend process improvements. Deliver coder education based on audit findings.
- Support denial prevention by reviewing coding-related rejections and suggesting coding clarifications.
- Track quality metrics (accuracy %,productivity, error rate) and prepare reports for leadership and clients.
Senior Medical Coder (ER-Facility, ER-Professional, Surgery with E/M OP / IP) - GEBBS HEALTH CARE SOLUTIONS - HYDERABAD
(2018-04 - 2023-11)
- Identifies appropriate assignment of CPT and ICD-10 cm codes for physician and facility services. Additional data elements may require to be gathered during the chart review process.
- Maintains a thorough understanding of assigned client coding specifics. Performs coding duties as appropriate for each site according to pre-determined schedules.
- Code medical records with ICD-10 CM, CPT-4, and HCPCS Level II coding, NCCI edits daily while maintaining accuracy and achieving productivity goals.
Clinical Medical Coder and Adjunct Instructor - THUMBAY HOSPITAL - DUBAI
(2015-11 - 2017-11)
- Coding the abstracted data by adhering to ICD 10 CM official coding guidelines
- To review OP/IP coding pre submission for completion and compliance as per official coding guidelines and JCIA standard, Strong proficiency of inpatient and outpatient coding.
- To coordinate with physicians for documentation improvement strategies.
- Claim Verification for medical necessities.
- Analyze the insurance claim and decide whether it is covered by the policy.
- Covering all aspects of coding Outpatient Physiotherapy, Dental, Surgery, Radiology, Laboratory, and Pharmacy codes.
- To make sure that all CPT codes are correct and as per tariff before submitting a claim.
- Submission of different insurance companies Claim processing
- Uploading claim in Dubai health authority.
- To review that all claims denied or rejected with denial code are appropriate and appeal them in a timely manner.
- Educating physicians on Improvement of patients documentation as per DHA guidelines.
- To review and resubmit denied OP cases as per DHA guidelines.
Associate-Medical coding - (ER-Facility & Professional) - OMEGA HEALTHCARE PVT.LTD - CHENNAI
(2014-02 - 2014-12)
- Responsible for day-to-day operations and to meet production and quality
- Maintained 98% of accuracy and productive quality.
- Working knowledge of ICD, CPT, HCPCS. Good knowledge of Anatomy, Physiology and Medical terminology.
Medical coding executive - (ER- Professional) - AGS HEALTHCARE SOLUTIONS - CHENNAI
(2012-07 - 2014-02)
- Performing ER coding for medical centers located in the United States Healthcare Network.
- Coding medical records with ICD-9, CPT, and HCPCS Level II coding, processing target claims daily while maintaining 98% accuracy and achieving productivity goals.
- Duties also included handling a wide variety of medical claims including ER. Permanently complied with CMS policies.
Staff Nurse - SRI RAMACHANDRA MEDICAL CENTER - CHENNAI
(2010-10 - 2012-06)
- Direct Patient Care: Perform assessments, administer intravenous medications and performed sterile wound care according to protocols and implement care plans.
- Documentation: Maintain accurate patient records (electronic health records).
- Collaboration: Work with doctors to develop individualized patient care strategies.
- Emergency Response: Provide acute care in high-pressure situations.
- Patient Education: Instruct patients/families on treatment plans and recovery.
