Medical Billing

AMIT RANA

Contact No: 052*******

E-mail:- ************@*****.***

CAREER OBJECTIVE:

To join an organization which provide equal opportunities for the growth of my knowledge and career.

SKILLS:

Experienced in medical coding more than 10 years (Evaluation and Management, Surgery, DRG coding and Radiology) with the computer skills.

In-depth knowledge of coding techniques and guidelines of medical coding.

Proficient in physician coding, inpatient coding, outpatient coding and facility coding.

Work experience of both 1995 and 1997 guideline for E&M.

Very sound knowledge of medical terminology, physiology and pharmacology.

Excellent in communication, interpersonal and organizational skills.

Working experience in Software Applications which include MS Word, MS Excel, MS PowerPoint. EDUCATIONAL QUALIFICATIONS:

Matriculation from CBSE Board.

Intermediate from H.P Board of School Education, Dharamshala in Medical Stream (PCB).

Graduation (B.A) from TGOU.

PROFESSIONAL QUALIFICATIONS AND TECHNICAL EXPERTISE:

Certified Professional Coder (CPC) of AAPC with 89% Marks.

Two Years Diploma in Pharma (A) from June 2005 to June 2007 from State Council for Vocational Training of Technical Education Board Dharamshala (H.P).

MS Dos, MS Windows, MS-Office (MS Word, MS Excel, Power Point, MS Access). CAREER PROFILE

Company Name : Zulekha Hospital Dubai

Designation : Medical Coder

Tenure : Nov 2016 to till date

COMPANY PROFILE:

The Zulekha Healthcare Group found its roots in 1964. Today, the Zulekha Healthcare Group includes two multidisciplinary hospitals in Dubai and Sharjah a multidisciplinary Hospital in Nagpur, Central India – Alexis, three UAE medical centres and three pharmacies. Zulekha Hospital Dubai is a 179 bed hospital established in 2004 which offers both inpatient and outpatient care covering a wide range of medical and surgical specialties. The facility boasts state-of-the-art operation theatre arrangements, emergency services, labor rooms and includes multiple centers of excellence such as Cardiology, Plastic Surgery, General Surgery, Oncology, Ophthalmology, Orthopedics, Urology, Gastroenterology, Dermatology and Physiotherapy.

JOB PROFILE & RESPONSIBILITY:

Coding Inpatient claims in terms of DRGs, CPTs, ICDs, billing HCPCS and Drugs.

Reviewing surgery notes and comparing it with approved CPT codes (Insurance approval), if any deviation/additional procedure/add on surgery the revision is requested to insurance companies.

Querying physicians for adequate documentation to reach more specific CPT codes for better reimbursement.

Coding for claims based on line item and justifying each service with diagnosis which are present in documentation

To review preapproval request of surgeries and procedures to assign appropriate CPT, HCPCS and ICD 10.

Good knowledge on CEED process and edits in order to achieve accurate coding.

Assisting in claims management and minimizing risk of financial loss. Company Name : Oriana Hospital

Designation : Insurance Incharge

Tenure : Jan 2015 to Nov 2016

COMPANY PROFILE:

Oriana Hospital is situated in Al Taawun, Sharjah. Oriana Hospital is a Multispecialty hospital with two operation theatre and doing all kind of orthopedic, laparoscopic, gynecological and cosmetic surgeries. The hospital provides medical services at the highest standards for both inpatient and Outpatient.

JOB PROFILE & RESPONSIBILITY:

Managing Insurance operations and productivity in hospital.

Contacting Insurance companies for the new services, procedures price fixing and empanelment.

Ensuring claims submission on timely basis and as per DHA requirement.

Resubmission of partially rejected claims with medical justification.

Attending meeting with Insurance companies for queries, reconciliation and follow up.

Reviewing the preapproval request of Surgeries and procedures and assigning appropriate CPT, HCPCS and ICD 10. Preparation of cost estimate for surgeries.

Coding the appropriate CPT for the procedures performed in OR and sequencing of diagnosis and procedures as per patient medical record.

Assisting Insurance company’s auditors and furnishing the required information.

Circulating the Memos and Notification received from insurance companies to responsible person.

Company Name : Al Salama Hospital

Designation : Medical Coder

Tenure : Nov 2012 to Dec 2014

COMPANY PROFILE:

Al Salama Hospital is situated in Tourist Club Area, Abu Dhabi. Al Salama Hospital is a Multispecialty hospital considered one of the leading hospitals and have been pioneering the role of Health Care since 1979. The hospital provides 24 hours medical services at the highest standards for both inpatient and Outpatient. JOB PROFILE & RESPONSIBILITY:

Coding Inpatient and Outpatient medical record with ICD-9, CPT, HCPCS level III code(s).

Coding the appropriate CPT for the procedures performed in OR and sequencing of diagnosis and procedures as per patient medical record.

Coding the proper service code for the reports.

Also working on Resubmission, remittance and rejections. Company Name : GeBBS Healthcare Solutions

Designation : Senior Medical Coder

Tenure : Aug 2011 – Sept 2012

COMPANY PROFILE:

GeBBS is a leading Healthcare outsourcing Solutions Company based in Englewood Cliffs, New Jersey with a multiple Global Delivery Centers (GDC) located in India. GeBBS service and delivery are based on the highly skilled professionals, robust processes, proprietary workflow engines, world-class infrastructure, in-house domain expertise and a commitment to the clients. GeBBS is a leading provider of healthcare Business Process Outsourcing services to Healthcare Providers (Medical Billing companies, Hospitals, Faculty Practices, ASC’s, LTC’s, etc.) and Pharmacies. JOB PROFILE & RESPONSIBILITY

Accurately assigning ICD-9-CM, CPT-4, HCPCS level III code(s) and sequence diagnosis and procedures per patient medical record for outpatient facility. Working as auditor for the client and doing E&M and ED.

Coded medical report of inpatient, outpatient and emergency room.

Maintained the 99 percent of accuracy and productive quality.

Also worked on Hierarchical Condition Categories (HCC) projects. Company Name : E4E Healthcare Solutions Pvt. Ltd

Designation : Medical Coder

Tenure : Feb 2010 to July 2011

COMPANY PROFILE:

e4e is an IT Enabled Services and Business Process Outsourcing Company, with an enviable client list of reputed G2000 companies.e4e has 5 delivery centers globally - 1 in US, 1 in Europe and 3 in India. e4e bring deep domain and contextual expertise in 2 segments, Healthcare Business Services and Interactive Entertainment (Games Testing, Customer Support Services & Localization). e4e carries a strong heritage of providing end to end Healthcare Services - through the Technology Platform to cost-effectively manage the complete ecosystem of claims adjudication, transmission, coding, billing and audits. JOB PROFILE & RESPONSIBILITY:

Coded medical record with ICD-9, CPT-4, HCPCS level III code(s) and sequencing of diagnosis and procedures as per patient medical record. Mainly doing E/M coding of Inpatient and Outpatient in Cardiology, Trauma, Myeloma, Burn, Cardiothoracic, Neurology, Gen. Surgery, SICU etc.

Coded inpatient, outpatient, emergency room and observation.

Maintained the 99 percent of accuracy and productive quality. Organization : Bansal Hospital

Designation : Pharmacist

Tenure : March 2008 to Feb 2010

JOB PROFILE & RESPONSIBILITY:

Dispensing of medicines as per Prescription.

Stock and inventory maintenance

Medicines, equipments and medical durable purchasing. PERSONAL PROFILE:

Date of Birth : 29th Jan 1984

Father’s Name : Shri. Mehar Singh Rana

Languages Known : English & Hindi

Hobbies : Reading Books & Surfing Net to Upgrade my Knowledge Email id : ************@*****.***

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