NAGARANI KEERTHIVASAN (CPC,CPB)

Email: adur77@r.postjobfree.com Phone: 317-***-****

SUMMARY

Certified Professional Coder with 7+ years' experience in investigating and processing health care claims. Subject Matter Expert at analyzing damages, interpreting policies, and negotiating payment solutions. Effectively managed multiple, high priority projects and provided exemplary customer service. Hardworking, highly motivated, energetic, always willing-to-learn and go es the extra mile to deliver exemplary customer service. Good communication skills and collaborative mindset.

SKILLS

ICD 10 coding, Claims Handling and Investigations, Claims Reports and Documentation, Medicaid and Medicare Policies, Policy Interpretation, Confidential Records Management, Evaluation of Liability Exposure, HIPAA Regulatory Compliance.

HCC - Optum – Remote (Mar 2022 - Present)

Assign appropriate codes using International Classification of Disease system (ICD-10) and/or Current Procedural Terminology (CPT) for diagnosis, procedures and services.

Responsible for correctly coding claims based on the services a patient receives in order to obtain reimbursement from insurance or government healthcare programs.

Read and analyze patient records extracting precise information from documentation, test results and reports.

Request diagnosis from physicians when not recorded on discharge and in cases where information is incomplete.

Maintain confidentiality regarding patient care information and chart contents.

Inform administrator of any incongruences noted in the chart record.

When appropriate clarify diagnosis, conditions and treatment information by working with the physician according to company policy and procedure.

Process physician reports needed to code appropriately and accurate.

A/R specialist- Riverview Health ( Sep 2021 – Mar 2022 )

Working in EPIC. Dealing denials.

Uploading claims directly in Insurance portals.

Contacting Insurance and resolving denials and pending claims.

Communicating coding denial trends

Appeals and reconsiderations

Review and Interpret carrier NC and LCD policies

Medical Coder & Biller - Hoosier Pediatric Dental- Fishers, IN (May 2019 – August 2021)

Determining accurate codes for physician’s diagnosis and procedures. Review medical record information to identify all appropriate coding to ensure it is aligned with the latest reimbursement policies.

Demonstrate analytical and problem-solving skills regarding barriers to receiving reimbursement and take active part in process and quality improvement initiatives

Review and bill current claims within timely filing limits. Review medical record documentation to identify all services provided by physicians.

Post both insurance and patient payments. Research charge processing and coding issues; review classification situations to determine the most appropriate codes.

Enter/Correct patient demographics. Work accounts in a timely and accurate manner, performing quality assurance for charges. Respond to patient inquiries. Follow up on open claims

CODER AND CLAIMS ADJUDICATOR - DELL (PEROT SYSTEMS)CHENNAI, INDIA ( Feb 2010 – Jan 2014 )

Coded ICD 10 codes for Medicare claims

Adjudicated complex medical benefits claims

Researched issues, requested additional information and collected written responses

Answered customer service inquiries about plan benefits

Followed all regulatory requirements and procedures

Developed and maintained tracking reports for all cases and inquiries

Stayed up to date on plan updates, regulations and policy changes

EDUCATION

Master’s in medical Biochemistry - (June 2009)

Vivekananda College of Arts and Sciences for Women – Periyar University, India

Bachelors in Biochemistry – (June 2007)

S. Vellaichamy Nadar College of Arts & Science - Madurai Kamarajar university, India

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