Senior Medical Coder/ Auditor/ Physician Liasion
Dubai Hospital, NTT Data
Total years of experience :14 years, 11 Months
Coding as per the standard DHA Guidelines and heading the coding team in Dubai Hospital in auditing
● Physician Liaison for any discrepancy in Medical Justifications
● Involving in cost estimation to guide the billing team
● Answering patient queries regarding the insurance policy and coverage
• Coding and Auditing the claims as per the DHA Guidelines and Uploading the Batches to DHPO and Editing XML file for any error
• Handling Neuron, Daman, Nextcare insurance companies for coding and submission
• Have knowledge of approval and denials and eRXcycle.
. Adjudicating the claims
• Inpatient Coding and auditing, E&M Coding and auditing
• Worked in Surgery Specialties like Gynecology, Integumentary, Orthopedic and Gastroenterology and Evaluation and Management Specialty
• Auditing the charts of the onshore coders and sending the feedbacks
• Submitting the claims to clearing house and checking the accuracy of the claims
• Attending the client calls and preparing the SOP’s
• Conducting team meetings and updating the client guidelines with the team
• Worked in Outpatient, Inpatient and Home Health Certification Specialty
• Worked in Denial Management department and reprocessing of claims which are denied
• Joined as a Second employee to the company and formed the standard set of guidelines for coding as per the clients
1) Omega Healthcare Management Private Ltd - Bangalore, Karnataka, India
Worked as Senior Medical Coder from January 2009 to December 2011
• Worked in Evaluation and Management section and Facility Coding Department
• Handled ten hospitals of both professional and facility part
• Assigning ICD-9, CPT-4 and Vol-3 codes with 98% accuracy
• Project on "Tuberculosis" in National Tuberculosis Institute in Bangalore (NTI) • Project on "Microbial Activities in Pasteurized Milk" in KMF dairy in Mallasandra in Tumkur • Project on "Immunotechnology" in Sridhar Bhatt Lab in Bangalore. Studied 1) ELISA, 2) SDS-PAGE ELECTROPHORESIS, 3) SOTHERN BLOTTING, 4) PCR DECLARATION:
• Conducting the Coding knowledge base test on monthly basis and reporting the performance to the manager • Sending the quality and production reports to the Manager and teammates ACADEMIC QULIFICATIONS: • Master of Science (MSc in Biotechnology) Completed in the year 2008 in Vidya Vahini First Grade College Affiliated to Tumkur University in Tumkur
• Bachelor of Science (BSc in Biochemistry, Microbiology, Zoology) Completed in the year 2006 in Government Science College Affiliated to Bangalore University SPECIAL ACADEMIC SKILLS: