Yerramsetty Muralidhar

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.

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%.

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)