Dr. Tejasvini Arora (Masters in Physiotherapy)

CPC (01287237)

Email ID:

acapz7@r.postjobfree.com

acapz7@r.postjobfree.com

OBJECTIVE:

Looking for a position as a medical coder with an organization that allows me to perform

high quality work and to grow both professionally as well as personally within the

organization

PROFESSIONAL EXPERTISE:

Masters in Physiotherapy (Orthopedics)

•

Certified Medical Coding Professional (CPC)

•

Good knowledge of basic US Health insurance terms like co-pay, co-insurance,

•

deductibles, OOP etc.

Proficient skills in the execution of facility coding, physician coding, outpatient coding,

•

and inpatient hospital coding procedures in an exact way

Knowledge of ICD-9, CPT and HCPCS codes

•

Knowledge of healthcare reimbursement

•

Informative in different areas like Pharmacology, Anatomy & Physiology, Psychology,

•

Advanced Medical Terminology, and other related medical sectors

Knowledge of HIPAA and patient confidentiality

•

knowledge related to medical coding methods and guidelines, including DRGs, ICD-9,

•

HCPCS, and CPT-4

KEY SKILLS:

Medical coding

•

Claim adjudication and Clinical Investigations (De-coding)

•

US Health Insurance

•

PRESENT ASSIGNMENT:

Organization : United Health Group

Duration : September’12 till date

Role : Clinical Investigator

KEY ROLE:

• Investigate, review, and provide clinical expertise in the application of medical and

reimbursement policies within the claim adjudication process through file review.

Perform ongoing analysis of medical record charts for the appropriate coding compliance.

•

A minimum of one year of professional coding experience

•

Perform clinical coding review to ensure accuracy of medical coding and utilizes clinical

•

expertise and judgment to determine correct coding & billing.

Adhere to state and federal compliance policies, reimbursement policies, and contract

•

compliance

Identify aberrant billing patterns and trends, evidence of fraud, waste or abuse, and

•

recommends providers to be flagged for review.

Maintain and manage daily case review assignments, with a high emphasis on an attention

•

to detail and quality.

Provides clinical support to the other investigative and analytical areas.

•

Serve as a clinical resource to other areas within the clinical investigative team.

•

complex decision making that maximizes investigation opportunities for our client

•

PAST ASSIGNMENTS:

Completed Masters in Physiotherapy (MPT) Orthopedics from Amity University, Noida,

UP (India) in Year 2012

Worked as Physiotherapist in various Hospitals in Delhi and Noida

Have a clinical experience of 1.5 years.

PROFESSIONAL QUALIFICATION:

Medical Coding CPC Certification

•

EXTRA CURRICULUR ACTIVITIES:

Languages Known : English, Hindi and Punjabi

Hobbies : Reading books, learning new things and watching movies

STATEMENT:

I hereby declare that the facts given in resume are correct to best of my knowledge and

belief

DATE: November 2013

PLACE: Noida (India)

Contact this candidate