Medical coder

PRATHYUSHA POTHIREDDY

Mobile-+971-*********

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

CAREER OBJECTIVE:

Seeking a challenging position in Healthcare Industry, utilizing my abilities developed through my experience where my technical, logical & analytical skills will greatly enhance the growth and success of the company. Seeking a position to learn constantly and contribute effectively and to grow along with the organization.

Medical Coding professional with more than 4 years of experience in medical coding and RCM.

PROFESSIONAL SUMMARY: WORK EXPERIENCE IN UAE

Medeor Hospital (Abu Dhabi, UAE) November 2018 to Till date

Designation: IP Coder

Responsibilities:

Worked as Medical Coder in Inpatient department (DRG, Day care/ Perdiem).

Reviewing inpatient medical records and assigning accurate ICD-10-CM, CPT, HCPCS and DRG codes for diagnoses and procedures.

Assigning and sequencing codes accurately based on medical record documentation.

Reviewing provider documentation to determine principle, secondary diagnosis, co-morbidities and complications.

Reviewing patient documentation and assess which information needs to be saved into the database.

Thorough understanding and application of medical necessity, DRGs for processing claims.

Involving in ensuring data integrity including appropriate sequencing and dispositions, resolving all coding edits prior to finalizing abstracts, compliant with HAAD/DOH regulations

Adhering to coding clinics and guidelines, and queried physicians for clarification as needed.

Querying physicians regarding incomplete documentation and further clarify on coding of diagnoses, procedures, etc.

Serving as a contact point for coding related queries.

Performing CCI Edits in bundling and unbundling procedures for a proper reimbursement from the insurance company (payers/third party) to the physicians.

Auditing coded charts for correct DRG, diagnoses and procedure assignment.

Expert in 3M coding and abstracting software.

Ahalia Hospital (Abu Dhabi, UAE) February 2018 to October 2018

Designation: IP Coder

Responsibilities:

Working Knowledge in HAAD Coding Guidelines and Submission.

Extreme knowledge with regards to Medical Coding guidelines and coding techniques with ICD-10-CM, ICD9CM, CPT, HCPCS, E&M (Evaluation and Management) Coding, and Medical Terminology.

Maintaining and applying coding knowledge as per coding guidelines wherever necessary and introduce innovative ways to minimize errors and enhance quality standards in the organization.

Analyzing patient medical records to ensure proper payment or reimbursement for medical services and reading medical diagnoses, conditions, and treatments.

PROFESSIONAL SUMMARY: WORK EXPERIENCE IN INDIA

PrimEra Medical Technologies (Hyderabad, India) July 2015 to November 2017

Designation : Medical Coder

Responsibilities :

Worked on EM report and IP DRG, correctly assigned PCS, ICD-10-CM Volume 3 codes and HCPCS codes based on the procedures performed by verifying the documentation properly.

Considering the factors like age, sex, discharge status, CC - Co-morbid /coexisting Conditions, MCC - Major Co-morbid / Coexisting Conditions and POA (Present on admission) indicators to determine the appropriate codes.

Coded 30 claims including Acute care, Short-term and Long-term Inpatient records.

Identified issues related to documentation in EMR and reported to supervisor.

Exceeded the quality expectations and productivity standards.

Assigning codes by using ICD 9/10-CM, PCS, and HCPCS.

Associate the diagnosis codes to the appropriate procedure codes (CPT) and sequence the codes in such a way as to ensure proper reimbursement.

Assess patient records by implement coding knowledge with productivity as per guidelines.

Identified issues related to documentation in EMR and reported to supervisor.

Exceeded the quality expectations and productivity standards.

Suggested on improvement of coding team performance, weekly reports of audited batches.

PROFESSIONAL CERTIFICATIONS:

CPC certified from AAPC with member id: 01404199

Certified ICD-10- CM Proficient

EDUCATIONAL QUALIFICATION:

Examination passed

Discipline

School/College/university

Year of passing.

Class

Percentage

Degree

B.Sc (Hons) Agricultural Science & Rural Development.

Loyola Academy Degree and P.G College, Secunderabad

2014

First

70%

Intermediate

Bi.P.C

St.Ann’s junior College, Guntur

2010

First

77%

SSC

SSC

Udaya Memorial High School, Jadcherla

2008

First

75%

KEY SKILLS:

Extreme knowledge in Inpatient Medical coding.

Extreme knowledge in Medical Coding guidelines and coding techniques (ICD-9/10-CM and PCS Coding, Modifiers, HCPCS, Medical terminology).

Areas of expertise in different specialties including Emergency Department (E&M), DRG, In-patient and Outpatient coding for Physician services.

Expertise in usage of concepts: CCI Edits, LCD, Vol III Codes, & HIPAA.

Expertise in usage of tools: Encoder Pro, Flash Code, and 3M.

Efficient in using MS Word, MS Excel, MS PowerPoint, and Good Typing Skills.

ACHIEVEMENTS:

Certificate of merit: received best outgoing student award during the academic year 2014.

Won many prizes during schooling in different aspects.

PERSONAL DETAILS:

Husband name : Prashanth Reddy

Gender : Female

Date of Birth and Age : 29th June 1992

Marital status : Married

Mother Tongue : Telugu

Nationality : INDIAN

Passport No : N3272146

Languages Known : English & Telugu

Declaration:

I hereby declare that the above-mentioned information is correct up to my knowledge and I bear the responsibility for the authenticity of these particulars.

Place:

Date:

(PRATHYUSHA.P)

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