Uma Rani

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.

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.

MBA - Hospital Administration - University of Madras (2013)

BSC - NURSING - SreeBalajicollegeofNursing (2010)

H.S.C - GovernmentGirlsHr.Sec.school (2006)

S.S.L.C - GovernmentGirlsHr.Sec.school (2004)