Medical Coder Certified
Resume:
SIVARAMJI KALIMUTHU
Certified Medical Coder
P R O F I L E S U M M A R Y
Certified coder with a can-do attitude and dedication to accuracy. Detailed orientated performer with medical terminology knowledge. To associate with a progressive and dynamic organization that would provide me with ample opportunities to apply my knowledge, skills, and talents to keep me updated with the latest trends in the field, which would in turn help me to build a prosperous career.
W O R K E X P E R I E N C E
Resubmission Officer February 2024 – Present
DR. Sulaiman Al Habib Hospital, Dubai, UAE
Key Responsibilities
- Handling coding, Resubmission (IP & OP), Reconciliation and Auditing claims to obtain payment.
- Review and identify the reason for denied claims.
- If coding errors are identified, reassign appropriate diagnosis or procedure codes.
- If denial is due to incomplete or missing documentation, then necessary information is gathered to justify the claims.
- Coordinate with treating physicians to prepare justification in support of valid claims.
- Ensure all the service is billed as per the agreed tariff to minimize the denial.
- Effective communication and collaboration with billing departments, coders, doctors, and insurance companies to resolve claim denials and secure reimbursement.
Insurance Coordinator Nov 2021 -Jan 2024
NMC Royal Hospital, Sharjah, UAE
Key Responsibilities
- Assigning proper ICDs and verifying CPT codes with documentation to avoid rejections from Insurance.
- Ensuring claims with proper approval and with all billing perspective that includes co - pay, Agreed Tariff’s.
- Uploading claims in DHPO/Riayati by generating XML/Jasen and clearing errors to minimize rejections
- Having experience in approval requisition in DHPO and Riayati.
- Keeping knowledge about resubmission
- Effective communication with doctors to maintain proper documentation
CONTACT
***********@*****.***
linkedin.com/in/siva-ramji-
7a6b9bb5
Villa 40, 45d street, AL-
Rashidiya, Dubai, UAE
EDUCATION
BE ECE 2012-2016
- SNS College of Engineering
SKILLS
CPT
Medical Terminologies
Medical Insurance Regulations
MS Office
3M Encoder Pro
Time Management
Analytic Skills
Documentation & Paperwork
LANGUAGES KNOWN
English
Tamil
PERSONAL STRENGTHS
COMMUNICATION -
Interpersonal skills – verbal,
problem solving and listening
skills in any administrative role.
ORGANIZATION - Helping
others, organizing a to do list.
Prioritizing tasks by the deadline
for improving time -management.
MANAGEMENT -
Management skills to direct
others and review others
performance.
PERSONAL DOSSIER
Quality Control Analyst May 2021 – Sep 2021
Excella Technologies, Chennai, India
Key Responsibilities
- Worked in a Quality control team to improve the efficiency and quality of the coders.
- Keeping knowledge about various medical coding process that include OP Clinic, Pain Management, Ancillary, ED (Profee and Facility).
- Providing feedback session to the coder to improve their productivity and quality.
Senior Medical Coder Mar 2019 – Apr 2021
Omega Healthcare, Bangalore, India
Key Responsibilities
- Worked in COE team for the improvement of coder efficiency and to develop automated software.
- Worked as a Quality Analyst for proper accuracy.
- Keeping knowledge about various medical coding process that include ED (Professional and Facility), Denial coding.
- Analyzing the coders performance to improving the quality and time management.
- Bringing new ideas on developing the software on automation.
- Providing proper feedback and accessing the knowledge of coders.
Medical coder Sep 2016 – Jan 2019
Visionary RCM, Coimbatore, India
Key Responsibilities
- Worked as a Master Audit Coder for accuracy check of Quality Coders.
- Keeping knowledge about HCC coding process.
- Delivering charts with more accuracy to the clients.
- Accomplishing targets on time with more accuracy. DECLARATION
I hereby declare that the above-mentioned information is true, and I bear the responsibility for the correctness of the above-mentioned particulars. SivaRamji K
PEROSNAL DETAILS
Gender : Male
Date of Birth : 19-02-1995
Nationality : Indian
Marital Status : Married
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