Development Team Lead.(Medical Coder)
K.S.A
Total years of experience :21 years, 4 Months
From February 2006 till date
Saad Specialist Hospital - Al-Khobar, Saudi Arabia (K.S.A)
It is Multi Speciality Hospital of 350 beds.
Job Title: Medical Coder
Job profile: I am solely responsible for coding new services by defining ICD-9 / ICD 10 CPT, HCPCS & DRG codes according to the international standards for all specialties including Oncology, initiating price breakdown by recommended service with market comparative prices to all required new services. Hold the responsibility to prepare reports on medical billing and rejections for all credit and insurance clients to define deficiencies. Preparing data for rejections and procedural with Diagnosis based on CPT / DRG procedures. Responsible for activating new services and patient use consumables then updating them into relevant service sheet and Charge sheet accordingly. Also, responsible to create financial breakdown of each medical service package (DRGs) to define actual cost for establishing charging price, the data also helps case managers in wards to cross check patient charges to obtain approvals from clients for non covered services. Working with ICD 10 Coding since 2010.
Medical Coding and Billing with ICD-9 and ICD-10 CM coding, a excellent medical knowledge for coding and billing the diagnosis, procedures and services in hospital with 10 years of experience in medical filed with excellent training in both ICD-9 and ICD-10 coding and billing in large 500 beds territory hospital and certified professional coder from AAPC, USA.
CODING AND BILLING OF NEW SERVICES AND DIGNOSISWITH PROCEDURES DONE BY ICD -9 AND ICD-10 CM CODING.
CODING AND PRICING OF NEW SERVICES AND CODING AND BILLING OF DIAGNOSIS AND PROCEDURES I 500 BED TERRITERY HOSPITAL SINCE 2006 TILL NOW.
From January 2004 till January 2006
TALLURI TECHNOLOGIES PVT LTD, SECUNDERABAD. INDIA
(MNC company USA based outsourcing)
Job Title: Coding and Billing Specialist
JOB PROFILE: My primary responsibility to code medical charts for out patients and in patients through the understanding of medical terminology, AMA guidelines, and procedures, assigning the appropriate CPT-4, ICD-9-CM, and special access codes based on medical documentation. Determining the provider and keying the information into the system and accurately apply, differences in coding requirements for various payers, clients and state programs.
Analyzes and resolves physician claim rejects and denials from the Billing
System or insurance carriers related to coding issues subject to Medicare,
Medicaid, BCBS, Aetna and other private Insurance companies.
AREAS OF EXPERTISE/SPECIAL SKILLS: • Good communication and analytical skills.
• Time management skills and good leadership qualities and ability to work as a team and achieve the set objectives.
• Posses a good blend of academic and practical knowledge to work as medical coder.
• Pleasing and pleasant personality.
• Hard working.
• Knowledge and experience in a health care setting.
• In-depth knowledge of third-party payer reimbursement policies and procedures.
• Have experience creating spreadsheets, reports, and trends data.
• Expertise to keep current with changes in ( as a member of AAPC)
Procedure and diagnoses coding and third-party payer reimbursement
Policies through continuing Education.
CODING AND BILLING OF MEDICAL CHARTS WITH ICD-9 CM AND ICD -10 CM
Clinical Coder Certification (HIMAA) or equivalent 2 years of coding experience within Queensland Health (or 2400 hours part time) AND The ability to operate independently to a satisfactory level of accuracy and timeliness across a range of the most common Diagnosis Related Groups relevant to the work environment. This is demonstrated through either: Endorsement by coding management of demonstrated competent application of the knowledge and skills required to perform at the A04 level OR Attainment of certain eligible coding qualifications (intermediary HIMAA or equivalent or higher) Whilst not mandatory, a relevant qualification noted below would be well regarded: Intermediate ICD-10-AM, ACHI and ACS Clinical Coding Course (HIMAA) Advanced ICD-10-AM, ACHI and ACS Clinical Coding Course (HIMAA) Certificate of External and Internal Clinical Coding Auditing (La Trobe University Australia)
CPC - ICD 10 CM certified in ICD 10 CM Coding and Billing AAPC - USA 2014 to 2015 HL7 in EMR Medesun Healthcare solutions - Hyderabad, Andhra Pradesh. 2011 to 2013 ICD -10 AM Expertise ….since 2008 till date. CPC - ICD 9 CM certified in 2004. CPC - certified in 2004 in coding and billing.
Comprehensive ICD 10 Coding Trained and Certified from Medesun Healthcare Solutions -2012. Diploma in Computer Applications from ICSS, India
QUALIFICATIONS: • M.A. (Master Degree in Eng. Lit.) completed in 2004 Osmania University Hyderabad India
CPC - AAPC USA (Certified Professional Coder) Certified in 2004 from American Academy of Professional Coders
• BSc. (Bachelor of Science) completed in 1999 Kakathiya University A.P. India PROFESSIONAL CERTIFICATION:
