Medical Coding & Revenue Cycle Specialist

Sushma Uppala

Medical Coding Specialist

Fort Mill, SC • 203-***-**** • ************@*****.***

Professional Summary

Detail-oriented Medical Coding and Revenue Cycle professional with training in ICD-10-CM, CPT, HCPCS Level II coding, medical terminology, healthcare reimbursement, claims review, denial management, and insurance billing processes. Experienced in reviewing clinical documentation, validating coding accuracy, analyzing claim denials, and supporting revenue cycle operations. Strong knowledge of HIPAA compliance, EHR systems, CMS-1500 claim forms, payer requirements, and coding guidelines. AAPC Certified Professional Coder.

Core Competencies

ICD-10-CM, CPT, HCPCS Level II Coding

Medical Coding Audits & Documentation Review

Claim Denial Analysis & Resolution

Revenue Cycle Management

Insurance Verification & Reimbursement

Accounts Receivable (A/R) Follow-Up

EOB & Remittance Analysis

EHR Systems

Medical Terminology & Anatomy

HIPAA & Regulatory Compliance

Data Accuracy & Quality Assurance

Provider & Payer Communication

Process Improvement & Root Cause Analysis

Microsoft Excel, Word, Outlook

Education & Training

Training & Certificate in Medical Coding

Joshi Medicode Technologies (Remote)

• Coursework in ICD-10-CM, CPT, HCPCS, Anatomy, Physiology, Medical Billing, Claims Processing, Revenue Cycle Management, and Healthcare Reimbursement.

• Performed coding exercises, claim reviews, denial analysis, and documentation validation using real-world case studies.

Bachelor of Science in Biotechnology

Siddartha Degree College, India

Relevant Qualifications

Review and validate diagnosis and procedure codes for coding accuracy and compliance.

Analyze coding and billing denials and recommend corrective actions to support claim resolution.

Interpret EOBs, payer correspondence, and claim edits to identify root causes of denials.

Support follow-up activities for unpaid, underpaid, and rejected claims.

Maintain knowledge of coding updates, payer regulations, and reimbursement guidelines.

Communicate effectively with providers, billing teams, and insurance representatives.

Assist with coding education, quality improvement initiatives, and departmental process enhancements.

Demonstrate strong attention to detail, productivity, and audit readiness.

Certifications

AAPC Certified Professional Coder (CPC) – Certified

Additional Skills

Medical Billing • Revenue Cycle Operations • Claims Follow-Up • Denials & Appeals • Data Entry • Analytical Problem Solving • Team Collaboration • Customer Service • Professional Communication

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