5 years Medical coding experience
ICD-10 Auditor
Specialties expert: Emergency department (physician and facility), Inpatient, Outpatient and Observation care of services.
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Venkat raghavan resume
1. Contact Number:91-9677168291
Alt Contact: 91-9150121439
Current location:Chennai,India
PERSONAL DETAILS:
Name:
DOB:
VENKAT RAGHAVAN R
Sex: (Male/Female) MALE
Marital Status: MARRIED
Current Company: ELI RESEARCH PVT.LTD, CHENNAI.
(Reporting to: SANKARA ADILAKSHMI, TEAMLEAD)
Current Designation: Medical codingAuditor.
Total years’ experience in Coding: 4.5 years
Current Salary: INR _5,04,000 per annum
WORK EXPERIENCE
Experience 1:
Start Date–End Date
(Total Duration:
September 2010 to
March 2011 - 7 months)
(Company Name) e4e healthcare
services
Designation: Medical coder
Duties & Responsibilities:
(Location)
Chennai
• Coding emergency department medical records with appropriate diagnoses and
procedures using ICD-9-CM and CPT-4 codes
• Review and abstract relevant clinical data/medical records to select and sequence
the appropriate ICD-9-CM diagnosis
• Processed up to 100 medical records daily while maintaining 95% accuracy and
achieving productivity goals.
Experience 2:
Start Date–End Date
(Total Duration: June
2011 to March 2014 –
2.5 years)
(Company Name) Elico Healthcare
services
Designation: Senior Medical coder
(Location)
Chennai
Duties & Responsibilities:
• Performed coding and auditing emergency department physician and facility
coding diagnosis and procedures using ICD-9-CM and CPT-4 classifications
• Processed up to 170 medical records daily while maintaining 95% accuracy and
achieving productivity goals
• Follow CMS coding guidelines and regulatory rules in governing corresponding
coding decisions.
• Compiled and maintained client side and internal feedbacks in order to circulate
it to the team members on daily basis
• Worked on claim denials if required.
2. Experience 3:
Start Date–End Date (Company Name) Omega healthcare
services
(Location)
Chennai
(Total Duration: March
2014 to May 2015 – 1
year)
Designation: Quality control analyst
Duties & Responsibilities:
•Performing audit and assure the assignment of complete, accurate, timely and
consistent codes by the medical coding unit includes ICD-9-CM, ICD-10-CM,
CPT-4, HCPCS Level II codes,IV Infusions, Injections, Hydration services.
• Processing up to 160 electronic health records daily while maintaining 95%
accuracy and achieving productivity goals
• Ensuring coded data accurately reflects service provided, based on
documentation, guarding against fraud and abuse
• Assigning work for the medical coders and auditors in terms of not affecting
TAT, Work volume received and Manpower availability and quality aspects
•Handling reports generation like medical coder’s performance reports and client
side requiring reports like acuity reports,document deficiency report for the
physician education purposes conduct by the client
• Compiling and maintaining client side and internal feedbacks in order to
circulate it to the team members on daily basis
• Working on claim denials as well as post-auditing in reviewing for the denials
reason.
• Managing a team of 10 members with respect to their productivity, quality and
improvement aspects.
Experience 4:
Start Date–End Date (Company Name) Eli research Pvt
Ltd. Services.
(Location)
Chennai
(Total Duration: May
2015 to present)
Designation: Medical coding Auditor, AAPC Audit services.
Duties & Responsibilities:
• Auditingmedical records ICD-9-CM, ICD-10-CM, CPT-4, and HCPCS Level II
codes,IV Infusions, Injections, Hydration services using Audicy, AAPC audit tool.
• Audit purpose solely is to educate providers on documentation improvement
which prevents denials dueto ICD-10 implementation.
• Processing up to 50 medical records on E&M audit, 80 medical records on ICD-
10 audit and 40 medical records on combo audits based on AAPC audit standard
guidelines with standard audit comments using Audicy tool, maintaining 90%
accuracy and achieving productivity goals.
• Compiling and maintaining client side feedbacks in order to discuss with audit
team.
• Attending the clientcalls weekly twice regardingauditprocess,audittool
challenges to provide effective physician education.
• Proctoringfor AAPC exams, based on requirements.
EDUCATION QUALIFICATION:
(Year of Passing) 2008 (University Name) Madras University (Location)
Chennai.
(Degree)(Percentage) 80 %
(Year of Passing) 2010 (University Name) Alagappa
University
(Location) Karaikudi
(Degree) (Percentage) 87 %
3. CODING CERITIFICATION
(Year of Passing) 2012 (Organisation) AAPC (Certification)
CERTIFIED PROFESSIONAL CODER - CPC
(Percentage) 89 %
(Year of Passing) 2014 (Organisation) AAPC (Certification)
ICD-10 PROFICIENCY TEST
(Percentage) 95 %
SPECIALITIES IN CODING
1. Emergency department codingboth professional and facility coding.
IT SKILLS
Ms Excel Beginner □ Advanced □ Expert □
Ms Word Beginner □ Advanced □ Expert □
Ms Office Beginner □ Advanced □ Expert □
LANGUAGESKNOWN:
1. English
2. Tamil
DECLARATION:
I do hereby declarethat the information provided above is true to the best of my knowledge.
Place: Chennai Thankingyou,
Date: 13/10/2015 R.VENKATRAGHAVAN