Experience

Accumed

• United Arab Emirates
• Hospitals and Health Care
• 200 - 300 Employee

• Senior Medical Coder

  • Dec 2019 - Present

   Effectively working for offshore client - SGH Hospital, KSA (Kingdom of Saudi Arabia) on UAE & Australian codingincluding processing coding, mapping, drug (SFDA) coding, radiology and laboratory investigation coding, consultationservice & consumable item coding & ACHI coding. Working on resubmission for revenue integrity like rejection & denial from insurance company. Reviewing all patient medical records for completeness, accuracy and compliance with accreditation agencies. Involved in applying official coding conventions & rules from Australian & American Medical Association & Centres forMedicare and Medicaid Services to assign diagnostic codes; coding diagnoses and procedures of all dischargedoutpatients’ records using an approved coding system. Accountable for collating data from medical records; uploading data unto the medical coding system for the purposes ofbilling and reimbursement. Efficiently reviewing, analysing & managing coding of diagnostic & treatment procedures contained in outpatientmedical records; also reviewing patient charts to understand health histories, diagnoses and treatments. Interacting with physicians and other healthcare staff to ask questions regarding patient services. Processing insurance company denials by auditing patient files, researching procedures and diagnostic codes todetermine proper reimbursement. Resubmitting claims after editing or denial to achieve financial targets and reduce outstanding debt.



NTT DATA Services

• United States
• IT Services and IT Consulting
• 700 & Above Employee

• Medical Recs Coding & Transaction Sr. Associate

  • Oct 2018 - Dec 2019

  Accountable for processing insurance company denials by auditing patient files, researching procedures and diagnosticcodes to determine proper reimbursement.Responsible for accurately selecting proper descriptive code when more than one anatomical location was indicated;reviewed medical records to select appropriate coding sequences Accountable for processing insurance company denials by auditing patient files, researching procedures and diagnosticcodes to determine proper reimbursement.Responsible for accurately selecting proper descriptive code when more than one anatomical location was indicated;reviewed medical records to select appropriate coding sequences



Access Healthcare Services

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Senior Client Partner

  • Mar 2017 - Oct 2018

   Handled various activities viz. reviewing charts and flagging incomplete or inaccurate information; used classificationmanuals to gain additional knowledge of disease and diagnoses processes. Responsible for keeping accurate log of all requests for medical information and records; maintained accuracy,completeness and security for medical records and health information  Handled various activities viz. reviewing charts and flagging incomplete or inaccurate information; used classificationmanuals to gain additional knowledge of disease and diagnoses processes. Responsible for keeping accurate log of all requests for medical information and records; maintained accuracy,completeness and security for medical records and health information



Omega Healthcare Management Services

• United States
• Hospitals and Health Care
• 700 & Above Employee

• Quality Control Analyst

  • Jul 2012 - Jul 2016

   Responsible for verifying proper ICD-9 coding on claims; involved in verifying signatures & checking medical charts foraccuracy and completion; reviewed services rendered and completed to reconcile codes. Accountable for collecting payments and interfacing with the clients; posted payments & collections on regular basis;transferred balances to correct payers. Looked after day-to-day operations of billing department including medical coding, payment posting, accountsreceivables and collections. Evaluated complex explanation of benefits forms to verify correct billing of insurance carriers and medical records tosatisfy insurance company mandates. Liaised with insurance providers to resolve any denied claims and resubmit; posted charges, payments and write-upsfor cardiovascular procedures; researched and followed up on denied insurance claims. Oversaw collected payments and applied to patient accounts; complied with all HIPAA privacy and security regulationsto protect patients' medical records and information. Effectively processed insurance company denials by auditing patient files, researching procedures and diagnostic codesto determine proper reimbursement.



E-care india pvt ltd

• Financial transactions executive

  • Apr 2011 - Jun 2012

   Effectively worked with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely andaccurate payments. Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts; looked after efficient cashflow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.  Effectively worked with medical payers such as Medicare, Medicaid, commercial insurances to obtain timely andaccurate payments. Handled high volume of in-bound calls pertaining to reconciliation of delinquent accounts; looked after efficient cashflow reporting, posted cash receipts and analyzed chargebacks, independently addressing and resolving issues.