.

HEALTHCARE MANAGEMENT & SERVICE DELIVERY EXCELLENCE

CROSS-GEOGRAPHICAL & CULTURAL TEAM INTEGRATION

STRATEGIC BUSINESS UNIT DELIVERY

18+ years of success through Client-focused Service Delivery, Center of

Excellence, along with leading and managing best HR practices

About me: A results driven manager with 18+ years hands on

experience and success in

Healthcare KPO and well versed in all major medical coding specialties.

Excellent management

skills with a client focused approach that fosters trust and allegiance.

Inspiring Manager with

great focus on solution driven approach, customer relationship with

experience in understanding

core functions of a business

About me: A results driven manager with 18+ years hands on

experience and success in

Healthcare KPO and well versed in all major medical coding specialties.

Excellent management

skills with a client focused approach that fosters trust and allegiance.

Inspiring Manager with

great focus on solution driven approach, customer relationship with

experience in understanding

core functions of a business

About me: A results driven manager with 18+ years hands on

experience and success in

Healthcare KPO and well versed in all major medical coding specialties.

Excellent management

skills with a client focused approach that fosters trust and allegiance.

Inspiring Manager with

great focus on solution driven approach, customer relationship with

experience in understanding

core functions of a business.

Savvy operations manager 18+ years hands on experience and

success in Healthcare KPO and well versed in all major medical coding

specialties. Excellent management skills with a client focused approach

that fosters trust and allegiance. Inspiring Manager with great focus on

solution driven approach, customer relationship with experience in

understanding core functions of a business.

Broad experience managing various teams, grow the coding business lines,

deal transactions and streamlined operations. Mobilizes top-tier talent to

create high performing cultures that consistently achieve in volatile

markets with expertise in healthcare consulting, coding operations,

transitioning, and population health analytics (both payer and provider

business models).

Core strengths include:

CAREER HIGHLIGHTS

a

aAA

. Responsible for the daily operations of coding division including

monitoring quality and quantity of workflow to ensure completion of

work assignments.

. Experience in Multi-Specialty & specific to E&M & Surgery Coding,

radiology and pathology.

. Should be able to code and audit as an SME, if needed to challenge the

SME within or external.

. Completely accountable for the Service Levels Agreement.

. Accountable for Team performance and Quality.

. Responsible for all process documentation and project planning.

. Assists in the development of coding policies and practice standards

. Recommend trainings to improve team performance

. Manage Customer Engagement and Client Interaction

. Manage the Client escalations with RCA

. Coordination with Internal and client teams

. Work towards continual improvement of processes and knowledge

enhancement at all times.

. Performing performance feedback and appraisals, doing career

assessments aligning them with the growth prospects of the

organization.

. Helping the other process which medical coding knowledge input for

example medical summarization and medical billing process.

. Managing team of coders and also medical summarization.

_

. Ensuring complete responsibility of the process related

deliverables

. Manages day to day Operations

. Handling client escalations Identifying, recommending and

implementing ways to increase the productivity and the

quality of the team

. Effective Resource Utilization. Attend to Client calls,

Status Meeting and Client feedback

. Hiring as per the process requirements

. Team handled: 105 coders.

. Responsible for consult, implement and provide clinical support to the

company healthcare tools/products and data mining.

.

. Review the client ICD-9 Claims experience and map them to equivalent

ICD-10 codes

. Develop the process and approach for conducting the mapping for the

ICD 10 diagnosis and procedure codes expected from the client.

. Process requires clinical analysis and interpretation of medical

coding relationships from multiple documents posted on CMS website.

. Several edits are developed and tested to serve as rule sets to decide

healthcare service reimbursements by Medicare.

. To develop backend rules to govern the coding guidelines. Extensive

research and data mining.

. Process also responds to end-user client related queries related to

the database.

. Evaluate and interpret the health records and reports to order to

accurately code diagnoses and procedures according to the recognized

classification systems.

. Responsible for assigning codes to diagnoses and procedures in order

to insure proper financial reimbursement from insurance companies.

. Clearing edits before filling of claims to minimize the chance of

claims being denied

. Proactively support the team manager in the achievement of team and

unit objectives

. Prompt release of coding reports to the charge entry team to bill

insurance companies and adhering to each insurance carrier's

policies and procedures

. Managed team of 25 coders.

. Process requires clinical analysis and interpretation of medical

coding relationships from multiple documents posted on CMS website.

. Several edits are developed and tested to serve as rule sets to decide

healthcare service reimbursements by Medicare.

. To develop backend rules to govern the coding guidelines

. Process also responds to end-user client related queries related to

the database

. Imparted coding raining both in-house and corporate for CPC

certification

. Organizing weekly calibration call with the client to analyze the

issues and challenges in term of quality

. Compliance with policies and statutory audits (HIPAA)

. Trained pilot batch of medical summarization project. On the job

training shadow production and help those to start production in

stipulated time.

. Audited files worked by team members.

. Multispecialty medical coding which involves working on ED coding, E/M

coding, radiology and denials management, General surgery, radiology,

denial and edits and surgical pathology.

. Some projects on auditing and training new batches of coding.

. Managed team of 35 coders.

. Manage a team of MTs. Auditing, workflow and quality parameters of the

team to achieve the standards.

. Worked in production giving the desired lines and quality.

. Training of new joinees.

Employer : Heartland Transcription and Services Private Limited

Position Held : Divisional Lead

Period of Service : December 21, 1998 to January 15, 2002

Job responsibilities:

Listen to the recorded dictation of a physician or other healthcare

professional.

Translate medical abbreviations to the specific long form depending on the

specialties and its documentation

Identify inconsistencies, errors, and missing information within a report

that could compromise patient care.

Submit the health records into electronic health record systems and for

physicians to approve

Went to Nepal to start with production unit and monitor the production and

quality of the new set up.

Perform quality improvement audits.

Managed team of 75 medical transcriptionists.

Ccommenced career with Offbit Marketing Services in February 1997.

Involved in various direct sales projects.

Technical trainings:

. Team leader's training for management skills.

. 90-hour training for CPC certification.

. Advanced training for E/M and radiology.

. 3 Months intensive training in medical coding based on CPC guidelines.

. Six-month intensive training program in Medical Transcription from

Heartland Information and Consultancy Services (training monitored by

head office in Toledo, Ohio).

. Advance training modules (eight modules having many operative reports

involving multiple specialties).

. Editor-Proofreader training.

Registration and Certification:

. Certified Medical Coder from AAPC.

. Member of American Association for Professional Coders.

Education:

1. Honors Degree in Science (Botany) from Delhi University.

2. Post graduate Diploma in Ecology and Environment (equivalent to Master's

degree) from Indian institute of Ecology and Environment.

3. Post Graduate Diploma in Human Resources and Development (3 years) from

National Institute of Human Resource Development, Madras, and (Recognized

by Govt. of India).

SOURAV DAS GUPTA, CPC

Mobile#: 989******* admx6v@r.postjobfree.com

21 Sahridaya Apartments, A-4 Paschim Vihar New Delhi 110063

> Risk management and performance metrics

> Healthcare Analytics

> Mid/Large client relationship management

> Population Health Retrospective & Prospective coding

> Provider/Payer Operations/Delivery

> Transition management

> Customer Engagement

> Provider Reports/Analysis

> RCM Operations

> Coding Operations

Freelancing on healthcare projects related to US healthcare May 2018- and

working as HR consultancy in automobile industry-till March 2020

KEIZER, GURUGRAM

MANAGER- OPERATIONS NOV 2015 - MAR 2018

E4E HEALTHCARE BUSINESS, NOIDA

MANAGER OPERATIONS, JULY 2015 - NOV 2015

EDIFECS TECHNOLOGY SERVICES, GURUGRAM

ANALYST, CODING OPERATIONS, FEB 2014 - JUNE 2015

UNITED HEALTH GROUP (OPTUM), NOIDA

DOMAIN SME, CODING OPERATIONS, SEPT 2012 - OCT 2013

ACCRETIVE HEALTH SERVICES (R1), NOIDA

SENIOR MEDICAL CODING ANALYST, SEPT 2009 - AUG 2012

GENPACT, GURUGRAM

BUSINESS ANALYST, JUNE 2008 - SEPT 2009

GLOBERIAN INDIA, FARIDABAD

QUALITY TEAM LEADER/TRAINER- MEDICAL CODING, FEB 2005 - MAY 2008

ALPHA THOUGHT TECH PVT LTD, NOIDA

MEDICAL CODER/QUALITY ANALYST, SEPT 2002 - JAN 2005

MEDECOM TRANSCRIPTION SERVICES, DELHI

SUPERVISOR- MEDICAL TRANSCRIPTION, FEB 2002 - SEPT 2002

ALPHA THOUGHT TECH PVT LTD, NOIDA

MEDICAL CODER/QUALITY ANALYST, SEPT 2002 - JAN 2005

HEARTLAND TRANSCRIPTION SERVICES, DELHI

DIVISIONAL LEAD, DEC 1998 - JAN 2002

EDUCATION, CERTIFICATION & TRAININGS

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