Keerthika R
Chennai
Summary
As a Senior Group Leader, excels in client management, team leadership, and addressing performance challenges. Recognized for resolving escalations and conducting effective performance reviews. Staunch and detail-oriented professional with 11+ yrs of experience in medical coding across various specialties, including ED Pro/ Facility, SDS, OBS, and Ancillary services.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Senior Group Leader
Access Healthcare Services Pvt. Ltd
04.2019 - Current
- Leading a team of 35 client partners, ensuring effective team management and collaboration
- Successfully completed 12 client transitions
- Handling multiple clients, maintaining strong relationships and meeting their needs
- Analyzing quality data and metrics to monitor performance and identify trends for corrective actions
- Developing and implementing quality control processes and procedures to maintain high standards of product quality.
- Collaborating with cross-functional teams to address quality issues and drive continuous improvement initiatives
- Managing client communication, including regular and transition calls
- Managing diverse medical coding processes, including ED Pro/Facility, SDS, OBS, and Ancillary services
- Consistently deliver results within the agreed-upon service level agreements
- Create and update SOP & process documentation promptly to ensure accuracy and compliance
- Manage end-to-end processes, conduct performance reviews, and perform root cause analyses
- Induct & train new team members, ensuring a smooth transition of process
- Maintain team stability by addressing attrition and shrinkage
- Provide constructive feedback on overall client partner performance
- Present key performance indicators through dashboards and reports
Quality Analyst
Ajuba Solutions Pvt. Ltd.
11.2014 - 03.2019
- Conduct daily performance reviews for the team, providing instant feedback
- Implement measures to enhance productivity and quality efficiency
- Create training materials for new team members, ensuring they are up-to-date with the latest coding guidelines and procedures
- Engage in weekly client calls, fostering effective communication
- Prepare comprehensive CAPA & RCA reports from audit findings
- Perform random quality assurance audits
- Conduct training, root cause analysis, driving process efficiency and cost savings
- Assign codes from the International Classification of Diseases (ICD), Clinical Modification (CM), Current Procedural Terminology (CPT), or Healthcare Common Procedure Coding System (HCPCS)
- Handle charging and data entry for each Emergency Department (ED) record, ensuring accurate billing for procedures such as infusions, injections, PQRS, RMK, and professional and facility fees related to Evaluation and Management (E/M) levels
Medical Coder
Omega Healthcare Management Services Private
08.2013 - 11.2014
- Assigning appropriate medical codes to diagnoses and procedures for patient records.
- Ensuring accuracy, completeness, and compliance with regulations in coding and billing.
- Reviewing medical records for documentation and coding accuracy.
- Communicating with healthcare providers to clarify information and ensure accurate coding.
- Adhering to coding guidelines and regulations such as ICD-10 and CPT coding systems.
- Resolving any discrepancies in coding to prevent claim denials and ensure proper reimbursement.
- Maintaining patient confidentiality and data security in handling medical records.
- Staying up-to-date with changes in coding guidelines and regulations to ensure compliance
Education
Bachelor of Science - Biotechnology
Meenakshi College For Women's
Chennai04-2013
Certification
- CPC
- Advance MS_Excel
Timeline
Senior Group Leader
Access Healthcare Services Pvt. Ltd
04.2019 - Current
Quality Analyst
Ajuba Solutions Pvt. Ltd.
11.2014 - 03.2019
Medical Coder
Omega Healthcare Management Services Private
08.2013 - 11.2014
- CPC
- Advance MS_Excel
Bachelor of Science - Biotechnology
Meenakshi College For Women's
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