Ramya Velagala
Summary
CPC Certified Medical Coder, passionate about delivering outstanding quality and service. Offering 6+ years of experience in industry with history of recognition for performance.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Insurance Coder
London Consulting Medical Center
11.2024 - Current
- Ensuring accuracy and consistency in medical coding.
- Assign accurate ICD and CPT codes for diagnoses and procedures.
- Stay updated on coding guidelines, regulations, and updates. Participate in coding quality improvement initiatives.
- Reviewed patient charts to better understand health histories, diagnoses, and treatments.
- Educating auxiliary and other staff regarding EMR documentation involves training them on proper documentation techniques, EMR system navigation, and compliance best practices to ensure accurate and efficient patient data management.
- Querying physicians regarding documentation involves reaching out to clarify unclear or incomplete information in patient records to ensure accurate coding, billing, and high-quality patient care.
- Resourcefully used various coding books, procedure manuals, and 3M
- Handling the Resubmission process involves identifying and correcting errors, gathering necessary documentation, and resubmitting claims to insurance payers in a timely manner to ensure successful reimbursement.
- Dealing with Reconciliation process involves Verifying coded data against source documentation, identifying discrepancies between coded data and claims submissions, and resolving coding errors or inconsistencies to ensure accurate claim reimbursement and compliance.
Senior Quality Analyst
United American Management Services
03.2020 - 10.2024
- Managed Quality Analyst team effectively, setting clear expectations and providing guidance on achieving desired outcomes related to product performance metrics.
- Conducted thorough assessments of patient records, recognizing discrepancies in the medical documentation.
- Managed outsourcing coding and performed quality analysis for 21 medical centers.
- Interacted with physicians and other healthcare staff to ask questions about patient services.
- Ensured accurate and compliant coding practices by performing on-site audits.
- Supported new hires in improving their coding proficiency through personalized training sessions.
- Scored an 'A' grade in compliance audits including TASNEEF audits.
- Expertise in managing submission, resubmission, and reconciliation procedures.
- Monitored ongoing projects to identify risks and implement preventive measures.
Medical Coder
United American Management Services
09.2018 - 03.2020
- Reviewed outpatient records and interpreted documentation to identify diagnoses and procedures.
- Reviewed patient charts to gain comprehensive understanding of health histories, diagnoses, and treatments.
- Ensured the precision, comprehensiveness, and confidentiality of medical records and health data.
- Maintained regulatory compliance by accurately applying coding conventions from AMA and CMS.
- Experienced in Submission and Resubmission processes.
- Achieved enhanced billing accuracy by accurately encoding patient information with the use of ICD-10-CM and CPT coding systems.
- Utilized strong time management skills to constantly meet and exceed code
completion targets. - Maintained strict confidentiality of all coded and other patient data at all times to safeguard patient welfare.
Education
Bachelor of Science - Pharmacy
Jawaharlal Nehru Technological University Kakinada
Kakinada, India05-2016
Skills
- CPT, ICD-10-CM and HCPCS level II
- Speed typing
- Decision-making
- Problem-solving
- Quality assessment
- Expertise in quality audits
- Time management mastery
- Quality control management
- Resubmissions
- Reconciliations
Certification
CPC - Certified Professional Coder from AAPC (2018)
Additional Information
SOFTWARES
- 3M and Encoder Pro
- Insta
- Concept
- Dok 32
- Unicare
- Clinic Care
- Clinic Software
- Clinic PRO
- Safecare (cortex)
- MEDAS
Timeline
Insurance Coder
London Consulting Medical Center
11.2024 - Current
Senior Quality Analyst
United American Management Services
03.2020 - 10.2024
Medical Coder
United American Management Services
09.2018 - 03.2020
Bachelor of Science - Pharmacy
Jawaharlal Nehru Technological University Kakinada
Similar Profiles
Rahish Madhavan Unnithan Prameela DeviRahish Madhavan Unnithan Prameela Devi
Radiology In-Charge/ Radiation Protection Officer (RPO) at London Consulting Medical CenterRadiology In-Charge/ Radiation Protection Officer (RPO) at London Consulting Medical Center
JOSE CARLO ESCARCHAJOSE CARLO ESCARCHA
Sterile Processing Technician Trainee at London Consulting Medical CenterSterile Processing Technician Trainee at London Consulting Medical Center
Ernest Smith Jr.Ernest Smith Jr.
Radiology Technologist / C.T. Technologist at B-Square Consulting / V.A. Medical CenterRadiology Technologist / C.T. Technologist at B-Square Consulting / V.A. Medical Center
Alyshia StricklandAlyshia Strickland
Medical Insurance Coder and Biller at Moultrie Internal Medicine/Dr. Clyde LamonMedical Insurance Coder and Biller at Moultrie Internal Medicine/Dr. Clyde Lamon
Kelly CoronaKelly Corona
Medical Record Insurance Coder at HCA Raulerson HospitalMedical Record Insurance Coder at HCA Raulerson Hospital