Certified Medical Coder

CURRENT DESIGNATION:

Certified Clinical & Dental Coder in

WELL HEALTH MEDICAL CENTER

L.L.C ABHUDHABI.

WORK EXPERIENCE:

Insurance Eligibility checking,

Preauthorization taking of services,

Clinical Coding, Dental coding,

Quality check, Denial Management,

Claim Submission and Resubmission

including self-pay as per HAAD,

AHIMA &INSURANCE COM PANY

STANDARDS by adhering HAAD

Claims & Adjudication rules and ICD-

10, CPT coding guidelines. Interact

with physicians, nurse and other

staffs regarding clinical

documentation and patient’s

demographic information for the

purpose of quality of EHR before

submission of each claims. Eligibility

checking and taking pre authorization

for necessary and appropriate

procedure as per medical necessity of

the patient.

PERSONAL INFORMATION:

Phone: 054*******

Email: ****************@*****.***

Nationality: Indian

Sex: Male

Marital status: Single

Date of birth: 02-02-1984

Address: Kunnumakkara house

Peramangalam Po

Manapady, Trissur

Kerala-680545

LANGUAGE KNOWN

English, Hindi, Malayalam, Tamil

PASSPORT DETAILS

Passport number: P8251419

Date of issue: 20-03-2017

Date of expiry: 19-03-2027

Place of issue: Cochin

CARRIER OBJECTIVES

To grow professionally to support the organization by bringing the quality and production in work, find the solutions and solve if there is any work related issues by professional expertise and competency through continuous learning, reference and self-updating by participating in work related program & seminars, So I can contribute myself for the growth of Organization as well.

EDUCATIONAL QUALIFICATION

MSc biochemistry (Madras university)

Institute: SRM College Chennai

Year: 2004-2006

BSc biochemistry (Calicut university)

Institute: Sree Krishna college Guruvayoor

Year: 2001-2004

Plus two

Institute: SRKGVMHS Puranattukkara

Year:1999-2001

SSLC

Institute: SDVHS Peramangalam

Year: 1999

PERFOMANCE PROFILE

Good knowledge about clinical documentation in EHR, quality driven coding by checking all exclusion in terms of diagnosis and CPT with medical necessity and specificity of each diagnosis and CPT. Nearly 5 year experience in outpatient coding, emergency department coding and E/M coding by using different EHR software 3M, EPIC, HBOC, ENCODER PRO and CLINIC PRO.

More than 3 year coding experience in NAVIGANT CYMETRIX PVT LIMITED Trivandrum India (Previously known to be REVENUEMED INDIA PVT LIMITED)

Currently working in well health medical center L.L.C in Abu Dhabi as a Quality controller cum Medical coder in insurance department since April 2018 with the specialty;

OB&GYNECOLOGY

PEADIATRIC

DERMATOLOGY

INTERNAL MEDICINE

DENTAL

ACHIEVMENT

Best employee award of month February 2015 (REVENUEMED PVT LIMITED Trivandrum India)

STRENGTH

Self-motivated, Loyal, Team worker,

Versatile and performance driven personality

Loyal, Team worker

Self-improvement by learning from mistakes

Optimistic, Smart worker

Adaptability to change

SHINIL VIJAYAN (COC)

CERTIFIED MEDICAL CODER

MEMBERSHIP ID: 01361405

PROFFESIONAL EXPERIENCE

Interpret health record documentation using knowledge of Anatomy, Physiology, Clinical disease processes, Pharmacology and Medical terminology to identify correct diagnosis and procedure as per ICD-10 CM and CPT coding guidelines.

Broad medical coding experience also includes Billing, Reimbursement, HIPPA rules, Insurance verification, scheduling, and report creation. Ensure healthcare providers meet specific documentation requirements that are essential in proper recordkeeping and claim reimbursement.

Ensure all coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse.

Serve as a liaison between the healthcare providers and billing department.

Sound knowledge regarding EHR documentation and importance of each element in the EHR.

Experience in TASNEEF AUDIT. Sound knowledge in HAAD Adjudication rules, icd-10, CPT guidelines, Evaluation and management coding and E/M leveling, Outpatient coding, Emergency, Ancillary and Radiology coding

Submission and Resubmission of Clinical and Dental claims.

JAWDA AUDIT Preparation for the Facility to make the general flow map, Clinical, Dental and Self pay coding processing flow map, Preauthorization flow map and relevant policies that comply with JAWDA AUDIT Standard. I hereby declare that the above information provided by me is true to the best of my knowledge and belief. I aspire to provide exceptional service with good quality in coding and production as well, according to HAAD Adjudication rules, AHIMA standard of coding ethics and also as per standard of organizations where I belong. PLACE: INDIA SHINIL VIJAYAN (COC)

Contact this candidate