Santosh Gupta- Manager Coding
Manager-Medical Coding & System implementation at Calibrated Healthcare Network- Claim this Profile
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Bio
Credentials
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CPC-ICD-10
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Experience
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Manager-Medical Coding & System implementation
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Jul 2018 - Present
• Provides strategic guidance and direction for system-wide coding services; create and manage a strong coding culture; ensures the recruitment, training, and retention of motivated competent coding managers, coding specialists, and coding auditors. • Responsible for the daily operations of coding division including monitoring quality and quantity for the workflow to ensure completion of work assignments. • Performs annual performance evaluations on staff. • Provides cost effective management of resources. • Work with our project management team determine which medical records validate for E&M Coding purpose. • Assists in the development of coding and abstracting policies and practice standards and communicates all policy changes as requested. • Oversees work assignments of system wide coding staff and adjusts work lists to accommodate volume and schedule Changes. • Participates on departmental and hospital programs for quality assessment and improvement and works with department management to improve the services provided. • Assist with the ongoing development, interviewing, Hiring and training of the middle town medical staff. • Perform corrective actions when necessary. • Performs quality review on all coders, providing feedback and education on areas identified as opportunities of Improvement.Involve for creating Initial Patient Benefit( Copay,Coins,Deductible) ,Interpretation and System Setup. • Working for System automation, helping team and developing Physician Fee schedule. Show less
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Manager-Medical Coding
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Feb 2017 - Present
• Accountability for the entire coding operations and its performance. • Ensure customer satisfaction by meeting the agreed SLA. • Provide process induction to all Team Members. • Conducting Weekly Team Review. • Sharing the audit status and error reports to client. • Denial Management. • Generating invoice reports for the projects handled. • Presenting Monthly Project review to Management. • Was involved in recruitment of coders. • Accountability for the entire coding operations and its performance. • Ensure customer satisfaction by meeting the agreed SLA. • Provide process induction to all Team Members. • Conducting Weekly Team Review. • Sharing the audit status and error reports to client. • Denial Management. • Generating invoice reports for the projects handled. • Presenting Monthly Project review to Management. • Was involved in recruitment of coders.
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Porteck Corporation
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United States
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IT Services and IT Consulting
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100 - 200 Employee
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Team Leader
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Jan 2016 - Feb 2017
• Medical Coding- Radiology Coding. • Having daily call with client and sharing the daily productivity, quality. • Had been working on Client emails on primarily. • Employee one-one session for their problems and try to resolve them. • Worked for weekly motivational plan for Team. • No Attrition had been done from my team. • Handled the Biggest Client and having 40 Coders under my team. • Had been sharing daily performance for the quality feedback with users which we got from the quality team and proving the motivations. • Had been involved for providing anesthesia coding training to the existing radiology coders and new coders. • Had been maintaining team Quality and High production. • Conducting weekly team meetings to update latest coding updates and client feedback. • Solution finding oriented. • Possess problem solving techniques. • Ability to work under pressure and meet deadlines. • Excellent follow up and organizational skills. Show less
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e4e Healthcare Business Services
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1 - 100 Employee
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Senior medical coder
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Nov 2014 - Jan 2016
Worked for HCC and Radiology coding and providing support to team, making reports, maintaining the high ageing inventory on priority basis. Was taking client calls and sharing the feedback whatever I got from the Client. • Working for Radiology & HCC Coding • Here I was providing support to the Team, and also taking more responsibility like maintaining the data, taking the client calls, sharing the feedback whatever I got from the Client. • I was the only team player who was putting in new Radiology project for making it to be established Show less
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R Systems
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United States
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IT Services and IT Consulting
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700 & Above Employee
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Certified Medical coder
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Jun 2014 - Nov 2014
• Mentor for new joiner. • Worked with R System as medical coder for Anesthesia medical coding based on surgery CPT code along with ASA codes Doing good numbers for charts along with quality. • Following HIPPA Policy while coding. • Using minimum Medical records as per US Law. • Mentor for new joiner. • Worked with R System as medical coder for Anesthesia medical coding based on surgery CPT code along with ASA codes Doing good numbers for charts along with quality. • Following HIPPA Policy while coding. • Using minimum Medical records as per US Law.
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UnitedHealth Group
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United States
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Hospitals and Health Care
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1 - 100 Employee
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Certified Medical coder and Denial Specialist
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May 2012 - Jun 2014
● Have been Certified In medical coding as Certified Medical Coder (CPC) ● Doing Radiology and E&M Coding. ● Have been involved in Medical Coder Training Program running in UHG Operation and providing them support who are NON CPC. ● Providing support in training batches. ● Have been involved in both types of work as handling denials processing and doing medical coding for Radiology. And E&M ● Provide expertise denials support by reviewing, researching, investigating, auditing. ● Analyze and identify trends and provides feedback and reports to reduce errors and improve denials processes and performance ● Making reports, creating macro to helping research benefits. ● Validating that benefits are input correctly into an internal system. ● Ensuring payments are in line with the customers' expectations. ● Presenting findings to other teams and auditors. ● Collaborating with other internal staff to prepare for audits. Show less
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IBM
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IT Services and IT Consulting
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1 - 100 Employee
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Senior Coding Denials specilist
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Apr 2007 - May 2012
● Handling the denials as per standard guidelines of USA Health Insurance and HIPPA Law. ● Maintaining the high ageing inventory on priority basis. ● Ensuring timely and professional responses to all complaints, requests and queries received. ● Research and compilation of answers for informational requests from customers. ● Responsible to reports, timely status of work assigned. ● Handling the denials as per standard guidelines of USA Health Insurance and HIPPA Law. ● Maintaining the high ageing inventory on priority basis. ● Ensuring timely and professional responses to all complaints, requests and queries received. ● Research and compilation of answers for informational requests from customers. ● Responsible to reports, timely status of work assigned.
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