Vkumar

CPC-certified Medical Coding professional with over 15 years of experience in Healthcare operations, General insurance, and medical coding. Expertise in E/M Outpatient and Emergency Department (ED) facility coding, ICD-10-CM, CPT, and HCPCS. Proven record of delivering 98% coding accuracy, strong auditing capability, and leadership experience as a Subject Matter Expert (SME).

I am looking for a position where I can utilize my coding skills to enhance accuracy in billing and revenue cycle management within a healthcare environment.

Medical Coder / SME - Optum Global Solutions Pvt. Ltd.

(2012-08)

• Perform accurate E/M OP and ED facility coding in compliance with ICD-10-CM, CPT, and HCPCS standards.
• Consistently maintain a 98% accuracy rate across audited charts and client reviews.
• Assign accurate diagnosis and procedure codes aligned with CMS guidelines and client policies.
• Conduct quality audits and support revenue cycle improvement initiatives.
• Provide coaching, feedback, and training sessions to improve productivity and accuracy.
• Communicate coding updates, regulatory changes, and project guidelines to team members.
• Worked on projects including TOPS, M&R, VACCN, CRT, Single Adjustment, PNO2, and E&I SAS.
• Committed to continuous learning to remain current on coding updates and client guidelines.
• Briefing team members before starting shift any update and plan for the Day.
• Manage leave and attendance tracker and support team engagement initiatives.
• Publishing all Weekly/Monthly and daily reports on production and quality.

Quality Analyst - EXL Service.com India Pvt. Ltd.

(2009-01 - 2012-07)

• Performed quality audits of insurance transactions to ensure compliance and accuracy.
• Provided structured feedback and coaching to associates to improve individual and team quality metrics.
• Prepared and published weekly and monthly quality performance reports.
• Conducted policy-level quality checks and identified process improvement opportunities.
• Generated detailed reports for Assistant Managers and stakeholders.

Bachelor's Degree - Allahabad University