Medical Coder Billing
Resume:
Pallavi P.R (Edison, NJ)
CPC and ICD-** CERTIFIED
Mobile: 848-***-****
Email: *****************@*****.***
OBJECTIVE:
Looking for a challenging role Specialty Medical Coder with growth potential that will utilize my skill experience resolve any issues to increase the productivity and coding quality accuracy and can be able to serve the organization, goals and mission.
PROFESSIONAL EXPERIENCE:
13 Years of US Health care Medical coding experience with various levels of complexity in coding department and Medical billing.
Experienced in successful management of diverse groups of people.
Experience in handling the team effectively by monitoring, training, motivating and tracking the progress on daily basis.
Ability to train any specialty of Coding with little time spent for research and understanding.
Experienced as a Coder- Biller – Have exposure to Denial Management for coding related issues.
Possess excellent communication and interpersonal skills, agreeable personality, positive attitude and perseverance to undertake challenging jobs.
Committed, result oriented, Innovative, hardworking person with quest and zeal to learn new technologies.
Excellent written and verbal communication skills.
Combine patience, determination, and persistence to troubleshoot client issues.
Technical Expertise:
I have strong knowledge with Experience in HCC (Retrospective, prospective, concurrent, Validation),Inpatient DRG(MS- DRG,APR-DRG),ED facility,E/M –IP/OP,Surgery.
Dynamic IT Health Care PVT ltd.,
Dec 2019- Dec 2022
Roles & Responsibilities:
Worked as Supervisor for HCC and Inpatient DRG coders.
Played a key role in stabilizing the Evaluation and Management, ED, Inpatient &Out Patient and Denials.
Responsible for handling and stabilizing different Inpatient& Out Patient facility projects.
Responsible for on time Auditing and processing charts of 3 facilities.
Attending client calls and updating the team on client specific guidelines.
System experience including: 3M, Encoder pro, HPF, Citrix, HDM,EPIC, CPSI,precise, Med Host and Medi Connect, EMR, E Clinical works, Sovera, Star
Worked as CAC REVIEW AUDITOR/CODER: Reviewed CAC assigned coding for Inpatient services and professional fee services Make recommendations from a coder’s perspective on any improvements that could be made to the CAC tool
MTSL India Pvt Ltd. Hyderabad, India
December 2017- May 2019
Roles & Responsibilities:
Worked as Team Lead for HCC and Inpatient DRG coders.
Played a key role in stabilizing the Inpatient &Out Patient and Denials.
Responsible for handling and stabilizing different Inpatient& Out Patient facility projects.
Responsible for on time Auditing and processing charts of 3 facilities.
Attending client calls and updating the team on client specific guidelines.
System experience including: 3M, Encoder pro, HPF, Citrix, HDM,EPIC, CPSI,precise, Med Host and Medi Connect, EMR, E Clinical works, Sovera, Star
Worked as CAC REVIEW AUDITOR/CODER: Reviewed CAC assigned coding for Inpatient services and professional fee services Make recommendations from a coder’s perspective on any improvements that could be made to the CAC tool
AGS Health Care PVT.LTD in Hyderabad.
June 2015- May 2017
Roles & Responsibilities:
•Worked as Team Leader for Multispecialty coding.
•Monitoring coders work and assist them to complete their work effectively and efficiently.
•Assigning the work to the team on daily basis.
•Create reports to update the company on the team progress
•Participate in interviews to identify the right resource for the company
•Training new joinee’s.
•Weekly meetings with the coders and clients
•Participate in audits on the new coding projects.
•Coordinating with team on the process follow and its requirements.
•Sorting out problems and escalating the issues to my senior operation manager on client wise.
•Training AR callers and Analyst on specialty based specifies.
Pradot Technologies. Bangalore, India.
October 2009- January 2012
Roles & Responsibilities:
•Worked as Senior Quality Analyst for Multispecialty coding
•Retro auditing of junior auditors
•Auditing.
•Monitoring coders work
•Coding pilot projects
•Training new joinee’s.
•Weekly meetings with the coders and clients
•Working on Coding Denials
•Participate in reviews and audits on the new coding projects.
•Coordinating with team on the process follow and its requirements.
•Sorting out problems and escalating the issues to my senior operation manager on client wise.
•Training AR callers and Analyst on specialty based specifies.
•File allocation to the team members
•Charge validation
•Transmitting batches to the clearing house
Omega Healthcare Management Services Pvt. Ltd.
Bangalore.
September 2007- October 2009.
Roles & Responsibilities:
·Worked as Emergency Medicine senior coder and responsible for assigning appropriate diagnosis and procedure codes using ICD-9-CM and CPT codes.
•Querying the physician for clarifications in the document.
•Attending client calls and updating the team on client specific guidelines.
•Excellent knowledge in medical terminology, anatomy, physiology and pharmacology
•Proficient in using coding software’s like 3M,Encoder Pro, Webstrat, Trucode etc.,
•Knowledge of Medicare, Medicaid and other payer’s guideline standards and rules of CPT, ICD-9, and CMS.
• Able to prioritize, multi-task and stay focused due to frequent interruptions.
•Able to use a considerable amount of independent judgment.
•Able to read and interpret documents; self-manage time with minimal supervision; and handle sensitive, private information with confidentiality and diplomacy.
Muscle Soft Solutions Pvt.Ltd
Hyderabad
June 2006- July 2007.
Designation: PSG Scoring Executive
Nature of Job: Worked on sleep study (polysomnography) as polysomnography scorer.
EDUCATION QUALIFICATION:
Master of Business Administration (Hospital Administration) .
Bachelor of Physiotherapy.
Personal Information:
Sex : Female
Marital Status : Married
Nationality : Indian
Languages Known : English, Kannada, Telugu, Hindi and Tamil.
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