Bhavana Carmel
Dubai,United Arab Emirates
Summary
Detail-oriented Medical coder and Insurance Coordinator with extensive expertise in RCM, denials, clinical and Gyn pathology coding, having in-depth knowledge in ICD-10, CPT and HCPCS coding guidelines, as well as UAE healthcare regulations including DHA, MOH and HAAD, alongside a strong foundation in physiology and medical terminology. Proficient in HIPAA compliance and adept at using Athena, Vital dx and Vital collect software. Proficient in using eClaim portal. Skilled in Microsoft Office applications including Word, Excel and PowerPoint. Committed to maintaining the highest standards of accuracy and confidentiality in all coding tasks.
Overview
4040
4040
years of post-secondary education
1
1
Certification
Work history
Insurance Coordinator
Life pharmacy Corporate Office
Business Bay, Dubai, UAE
09 2022 - 09 2023
- Verified and processed insurance claims for accuracy in patient information, dosage, coverage, and eligibility, ensuring compliance with DHA guidelines and preventing claim rejections or delays.
- Performed claim submission and resubmission with accuracy, adhering to payer-specific guidelines to ensure timely reimbursement.
- Managed reconciliation of payments, identifying variances and resolving underpayments, denials and rejections effectively.
- Performed final DHA audits of insurance claims to ensure accuracy, identifying discrepancies and implementing corrective actions to resolve issues and maintain regulatory adherence.
- Managed cancellation, billing, and daily updating of insurance claims.
- Updated and finalized patient copay amounts in alignment with insurance coverage policies, ensuring accurate records and transparency.
- Provided training and mentorship on insurance processes and claim submissions, fostering consistent knowledge and best practices across team.
- Assigned daily tasks to trainees, monitored progress, provided support, and led team meetings to enhance performance and development.
MEDICAL CODER
Starmark Healthcare PVT LTD
Mysore, India
12 2020 - 06 2022
- Specialized in RCM, denials, clinical and Gyn pathology coding.
- Experienced in assigning and sequencing accurate ICD-10, CPT and HCPCS codes for documented diagnoses and procedures to patient records with appropriate coding guidelines.
- Verified accuracy, completeness, and specificity of diagnosis codes based on services rendered, ensuring compliance and reducing claim denials, improving claim submissions, and reimbursements.
- Streamlined auditing processes, ensured quality and accuracy of coding to minimize errors, and support revenue cycle efficiency.
- Collaborated and worked closely with providers to clarify and ensure accurate documentation of services.
- Ensured all coding activities align with latest healthcare regulations, reducing risks, and enhancing claim acceptance rates.
Education
MEDICAL CODING AND BILLING -
CIGMA MEDICAL CODING ACADEMY
03/2020 - 06.2020
B.VOC RENEWABLE ENERGY - Bachelors
ST. ALBERTS COLLEGE, ERNAKULAM
06/2016 - 03.2019
Skills
- ICD-10-CM, CPT and HCPCS coding
- Knowledge in DHA, MOH and HAAD guidelines
- Knowledge in physiology and medical terminology
- Knowledge in HIPAA
- Proficient in using eClaim portal
- Software knowledge in Athena, Vital dx and Vital collect
- Microsoft Office (Word, Excel, and PowerPoint)
Languages
English
Hindi
Malayalam
Tamil
Certification
- AAPC CPC certified (ID: 01840087)
Timeline
Insurance Coordinator
Life pharmacy Corporate Office
09 2022 - 09 2023
MEDICAL CODER
Starmark Healthcare PVT LTD
12 2020 - 06 2022
MEDICAL CODING AND BILLING -
CIGMA MEDICAL CODING ACADEMY
03/2020 - 06.2020
B.VOC RENEWABLE ENERGY - Bachelors
ST. ALBERTS COLLEGE, ERNAKULAM
06/2016 - 03.2019
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