Risk Adjustment Medical Coding

Neelima Pathuri

***** * ********* **, ********, IA, 50131

Cell: 480-***-**** ************@*****.***

Professional Summary

Certified Professional Coder (CPC) with hands-on experience in HCC coding and a strong academic background in biochemistry and pharmacy. Adept at ICD-10-CM coding, risk adjustment, and EHR systems such as Epic and 3M. Proven ability to meet production targets with high accuracy while maintaining compliance with CMS and HIPAA regulations. Open to full-time, remote, or on-site medical coding opportunities. Professional Experience

HCC Medical Coder – Augustas (January 2025 – March 2025)

● Assigned accurate ICD-10-CM codes for risk adjustment under CMS-HCC guidelines

● Maintained 95–98% coding accuracy while minimizing abstract errors

● Collaborated with team on denial management and claims validation

● Utilized EHR systems including Epic and 3M

● Ensured HIPAA compliance and documentation integrity Substitute Teacher – Johnston Community School District, IA 2019 - 2024

● Managed high school classes for Math and Science subjects

● Maintained effective classroom discipline and student engagement

● Coordinated with teachers and administration on daily teaching activities Lecturer in Medical Laboratory Technology – Pulipati Prasad Paramedical College, India Jun 14 - May 16

● Delivered lectures in Biochemistry, Anatomy, and Physiology

● Created and implemented daily lesson plans and examinations

● Coordinated student events and contributed to curriculum development Lab Technician (Biochemist) – Medwin Hospitals, India Aug 10 - May 14

● Conducted clinical analysis on body fluids and tissue specimens

● Validated abnormal results and determined need for further tests

● Liaised with healthcare staff to ensure quality diagnostic service

● Developed and improved testing methods with high manual precision Education

University of Madras – M.Sc. in Biochemistry

Acharya Nagarjuna University – Diploma in Pharmacy Certifications

● Certified Professional Coder (CPC), AAPC (Magna Cum Laude)

● Certified in AI in Medical Coding and Billing, AAPC Skills

Medical Coding:

● ICD-10-CM, CPT, HCPCS Level II

● HCC coding and Risk Adjustment methodologies

● CMS, AHA, AMA guidelines

● HIPAA compliance & documentation review

Technical Proficiency:

● EHR systems: Epic, 3M, Risk Adjustment Tools

● Coding and billing software

Soft Skills:

● Strong problem-solving and analytical thinking

● Excellent communication and teamwork

● Detail-oriented, self-motivated, and organized

Additional Information

● Open to remote or on-site entry-level medical coding roles

● Available for full-time positions in HCC, outpatient, or general medical coding

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