Karthiga Kumari Karunagaran CPC CCS
Dubai
Summary
Professional Medical Coder with 12 years of experience, including 10 years in US healthcare and 2 years in UAE healthcare. Expertise in medical coding, internal audits, Claim submission, claims denial analysis, and prior approval processes. Proficient in ICD-10, CPT, and HCPCS coding systems, ensuring compliance and optimizing reimbursement. Skilled at resolving coding discrepancies and improving claims submission to reduce denial rates. Collaborative team player with a focus on maintaining accurate documentation and efficient workflows. Committed to supporting quality patient care and enhancing operational efficiency in claims processing.
Overview
2026
2026
years of professional experience
1
1
Certification
Work History
Medical Coder
Emirates Specialty Hospital
11.2023 - Current
- Reviewed Emergency, outpatient and Day case DRG records and interpreted documentation to identify diagnoses and procedures.
- Improved accuracy of medical coding by thoroughly reviewing patient records and assigning correct codes for diagnoses and procedures.
- Utilized advanced knowledge of anatomy, physiology, and medical terminology to accurately assign codes for complex or rare diagnoses and procedures.
- Interacted with physicians and other healthcare staff to ask questions regarding patient services.
- Maintained a high level of productivity while consistently meeting deadlines for claim submissions.
- Processed and submitted accurate insurance claims for services provided, ensuring all required documentation was complete and in compliance with payer requirements.
- Managed and resolved denied claims by identifying root causes, including coding errors, missing documentation, and incorrect patient information.
SME
Cognization Solutions India PVT Ltd
7 2021 - 07.2023
- Analyze and resolve claim denials for outpatient services and emergency department, ensuring proper documentation, coding, and adherence to payer policies to facilitate timely reimbursement.
- Review insurance claim rejections and denials, identifying root causes, and collaborating with medical providers, coders, and payers to correct errors and resubmit claims.
- Prepare and submit appeals for denied outpatient claims, including gathering necessary supporting documentation, medical necessity justification, and coding clarifications.
- Monitor denial trends for outpatient services to identify patterns, recommending process improvements to reduce recurring claim issues and increase claim acceptance.
Medical Coder Cum Insurance Coordinator
Novomed Specialized Surgical hospital
12.2020 - 05.2021
- Taking approvals for medical procedures, Outpatient investigations and dealing with queries from insurance and follow up
- Applying approval in E-claim link and dispatching approval for Outpatient and DRG cases
- Assigning ICD, CPTs and DRG tracker for approval requests as per Coding compliances
- Querying provider for medical necessities
- Coordinating with insurance companies for benefit coverage and explaining same to Nurses and providers
Senior Medical Coder and Coding Auditor
Ajuba Solutions PVT Ltd
08.2012 - 11.2020
- Conduct comprehensive audits of medical records and coding to ensure accurate assignment of ICD-10, CPT, and HCPCS codes, identifying discrepancies and recommending corrective actions.
- Generate detailed audit reports to provide feedback on findings, coding trends, and actionable recommendations for process improvements and education.
- Reduced claim denials by identifying and addressing common errors in the coding process.
- Provided valuable feedback on coder performance following audits, fostering an environment of continuous improvement within the team.
- Enhanced team productivity by providing ongoing training and support to junior medical coders.
Education
Bachelor of Science - Microbiology
St.Josephs College of Arts And Science
Skills
- Anatomy and physiology
- ICD-10 coding
- CPT coding
- Medical terminology
- Clinical documentation review
- Denial management strategies
- Time management
- Claim Submission
Certification
- CPC, 10/01/14
- CCS, 06/01/23
Passportvalidity
11/01/31
Personal Information
Visastatus
Spouse Sponsor
Languages
English
Tamil
Malayalam
Passportno
U8987932
Timeline
Medical Coder
Emirates Specialty Hospital
11.2023 - Current
Medical Coder Cum Insurance Coordinator
Novomed Specialized Surgical hospital
12.2020 - 05.2021
Senior Medical Coder and Coding Auditor
Ajuba Solutions PVT Ltd
08.2012 - 11.2020
SME
Cognization Solutions India PVT Ltd
7 2021 - 07.2023
Bachelor of Science - Microbiology
St.Josephs College of Arts And Science
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