Curriculum Vitae

Career Objective:

To contribute to the overall success of a progressive, growth-oriented organization that will benefit from my knowledge and skills acquired through education and experience, and that will provide me with an opportunity to grow professionally.

Skill Sets:

Having over 11 years of working experience in Medical Coding including 5 years in UAE.

Comprehensive knowledge of Current Procedural Terminology (CPT) and International Classification of Diseases Clinical Modification (ICD-9-CM & ICD-10-CM/PCS/HCPCS)

Exposure over Evaluation and Management Services in modalities like Emergency Department, Out Patient, In Patient, Consultations etc.

Performed diagnosis coding risk adjustment (HCC) purposes

Knowledge of IP-DRG and Surgery Coding

Having Working Exposure on Radiology, Laboratory, and Pathology Coding.

Worked on Denials for Medical Necessity

Skilled in reading and interpreting medical terminology and procedures

Proficient in computer skills and encoder system

Worked for Government Hospital projects like SEHA-Abu Dhabi Emirate and DHA – Dubai in UAE

Excellent typing skills and command over the Microsoft Excel

Hands-on experience on coding softwares like 3M Software, EPIC, Encoder pro, Cerner Millennium, Webstrat,, Code Remote, ChartSync, and ChartFinder

Professional Certifications:

Certified Coding Specialist (CCS) from AHIMA in June 2011 (Certificate No. C008521)

Certified Professional Coder (CPC) from AAPC in June 2013 (Certificate No. 01277636)

Certified Professional Medical Auditor (CPMA) from AAPC in December 2017 (Certificate No. 01277636)

Certified Documentation Improvement Practitioner (CDIP) from AHIMA in November 2020 (Certificate No. 240739)

Educational Qualification:

Registered Pharmacist with Diploma in Pharmacy from Govt. Polytechnic College, Masab Tank, Hyderabad, India.

Intermediate from Sri Aravindo Junior College, Choutuppal, Telangana.

SSC from ZPHS Puttapaka, Mdl. Narayanapur, Dist. Nalgonda, Telangana.

Work Experience:

Organization: NTTDATA Services, Dubai, UAE. (for Dubai Health Authority Hospitals)

Duration: March 2017 to October 2019

Designation: Medical Coding Senior Associate

Performing Emergency Department/OutPatient/Inpatient/Daycare Coding on all diagnoses, procedures, laboratory services, and radiology services with the most accurate and descriptive ICD-10-CM and CPT-4 and reimbursement purposes for DHA facilities.

Appending appropriate DSL codes based on the Services

Reporting DDC Codes for Pharmacy

Ensure to check all necessary check points like eligibility, pre-authorizations and general exclusions to avoid denials

Ensure to query the physician for clarification and for additional documentation prior to assigning codes Consistently maintaining the productivity standards with high level of accuracy

Performing Onsite Clinic coding in supporting RCM

Organization: TAWAM Hospital (SEHA-Govt. Sector) through Middle East Health Information Management, Al Ain, UAE.

Duration: May 2015 to Jan 2017

Designation: Clinical Coder

Performing Emergency Department Coding on all diagnoses, procedures, professional services, and supplies with the most accurate and descriptive ICD-9-CM/ICD-10-CM and CPT-4 (E&M level of services) and reimbursement purposes.

Performing Outpatient coding for various specialties

Dealing with ED denials for Medical Necessity on all the CPTs, Radiology, Labs, and Medications.

Having exposure to Multispeciality Hospital.

Responsible to inform and educate the physicians on proper documentation requirements.

Organization: Elixir Claims Management, Abu Dhabi, UAE.

Duration: October 2014 to April 2015

Designation: Medical Claims Auditor

Perform coding audit on all diagnoses, procedures, professional services, and supplies with the most accurate and descriptive ICD-9-CM and CPT-4 (E&M level of services) and reimbursement purposes.

Responsible to audit various claims, which were previously coded and randomly selected for audit. Checking the appropriate code selection and appropriate E/M level based on documentation and coding guidelines.

Responsible for Audit/Review (retrospective and/or prospective) provider documentation to ensure compliance with medical regulations.

Timely and accurate submission of Medical Claims to Insurance Companies

Educate physicians, Coders, and other healthcare professionals regarding documentation requirements for accurate coding and reimbursement.

Assist in updating physicians' office encounter forms.

Organization: United Health Group, Hyderabad, INDIA .

Duration: March 2012 to March 2014 (2 years)

Designation: Subject Matter Expert

Performed diagnosis coding risk adjustment (HCC) purposes

Worked on various projects like HCC, HQPAF, CV, and HEDIS measures

HCC (Hierarchical Condition Categories) is designed to assign scores to health carriers members' based on their degree of sickness. CMS using the HCC model makes for a more accurate prediction of health care/medical cost

To Capture the Potential HCC's and Rx HCC'S from the medical documents

Reviewed medical record information to identify all appropriate coding based on HCC guidelines.

Responsible for internal coding audits and provide feedback to the freshers and train them with HCC Coding Resources.

Responsible for conducting team meetings regarding audit findings and updates to improve the quality of coding

Maintaining records in respect to the targets achieved and daily productivity

Organization: PhyCare Services Pvt. Ltd., Hyderabad, INDIA.

Duration: December 2007 to March 2012 (4 years 4 months)

Designation: Senior Executive Quality Analyst

Worked on Provider side of coding

Coded Evaluation and Management (E/M) services provided by physicians in various departments including Emergency Department, Out Patient, In Patient, and Consultation Services directly from the medical record using the appropriate diagnosis (ICD-9) and treatment codes (CPT-4) for billing and/or statistical purposes

Monitor quality of the coded medical records of Emergency Department and Out Patient

Worked on Coding Edits, which deals with medical record documentation errors to ensure and support the chart coded accurately

Coordinating with the Billing Team for the processing of Cleared Charts

Responsible for educating teammates on proper code selection, documentation, and procedures

Accomplishments:

Also worked in Healthcare Industry as Medical Transcriptionist for 2 years in CBay Systems, Hyderabad, INDIA.

Attained Special Recognition Award twice for reaching the quality score of 95% and more for 6 consecutive months and for reaching monthly target with 120% productivity.

Special Expertise Award once in the previous organization (UHG).

Technical Skills:

Extremely knowledgeable with regard to Medical Coding Guidelines and Coding Techniques (ICD-9-CM,ICD-10-CM/PCS,CPT, and HCPCS), proficient in Physician Coding, Outpatient Coding, Inpatient Coding, and ED Coding.

Able to type 50+ WPM and familiar with MS Office basics.

Personal Skills:

Highly organized.

Flexible & adaptable.

Problem solver and result-oriented.

Can work independently as well as in a team.

Positive attitude - creating a positive work environment

Declaration:

I do here by declare that the information furnished above is true, complete, and correct to the best of my knowledge and belief.

Place: Dubai, UAE. Yours Sincerely,

Date: Venugopal Kolanu.

Venugopal Kolanu, CCS, CPC, CPMA, CDIP.

__

Dubai, UAE.

Mobile: 971-*********

adjx2v@r.postjobfree.com

Personal Data:

DOB: August 4, 1984

Marital Status: Married

Nationality: Indian.

Language Proficiency:

English, Hindi, Telugu.

Passport Details:

Passport No: Z2846568

Date of Expiry: 10/06/2024

Place of Issue: Hyderabad.

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