Yerramsetty Muralidhar
Certified Medical Coder with expertise in HCC coding and ICD-10 compliance
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About
Certified Medical Coder with 3.6 years of experience in HCC coding, ICD-10-CM guidelines, and risk adjustment. Proficient in Medicare/Commercial projects, retrospective/prospective audits, and physician collaboration for documentation clarity. Adept at leading teams, mentoring juniors, and implementing annual ICD-10 updates. Recognized for 98%+ coding accuracy and process optimization across clients like Aetna, Anthem, and Centene MA.
Experience
FPC Coding - COTIVITI
Aetna project
HCC Specialist (FPC Coding) - INNOVALAON
Anthem Medicare project
Coding Analyst & Quality Auditor - Ciox
Oscar & Aetna projects
FPC Coding - OPTUM
Coding Analyst & Quality Auditor - CENTENE MA
Coding Analyst & Quality Auditor - CENTENE
ACA project
FPC Coding - FBL Tallix
Certified Medical Coder - Multiple Clients (Aetna, Anthem, Oscar, Centene MA)
- Captured HCC conditions using ICD-10-CM guidelines and project-specific criteria for Medicare/Commercial plans.
- Conducted retrospective and prospective chart reviews to validate coding accuracy, reducing claim denials by 15%.
- Collaborated with physicians to resolve documentation discrepancies, ensuring compliance with CMS standards.
- Performed QA audits on 500+ charts monthly, maintaining 98% accuracy across projects.
- Trained and mentored 5+ junior coders on ICD-10 updates, HCC capture, and shift management.
- Implemented 2022-2023 ICD-10-CM updates in workflows, ensuring compliance with October 1st deadlines.
- Worked in rotational shifts (day/night) to support 24/7 project timelines and client demands.
- Provided on-call support during critical audits to address urgent coding discrepancies.
- Reduced coding errors by 15% in Centene MA through meticulous chart reviews.
- Awarded "Top Performer" at Centene MA & ACA for achieving 98% audit compliance.
- Streamlined shift-handover protocols, boosting team efficiency by 12%.
Education
M.Sc - Organic Chemistry - Sri Venkateswara University (2021)
B.Sc - BZC - Rayalaseema University (R.U) (2019)
Intermediate - Board of Intermediate Education (2016)
SSC - Board of Secondary Education (2014)
