Ninitha Alexander
Abu Dhabi,UAE
Summary
Experienced AAPC Certified Medical Coder with a strong expertise in CPT codes, ICD-10 diagnoses, dental codes, and Tasneef audits, backed by over 4 years of hands-on experience in medical coding. Driven professional with keen aptitude for leadership and problem-solving. Demonstrates strong communication and analytical skills, combined with proactive approach to project management. Committed to driving organizational success through strategic initiatives and collaborative teamwork.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Approval Officer/ Medical Coder
Samaya Specialized Center
Abu Dhabi, UAE
09.2023 - 03.2025
- Apply medical knowledge and best insurance practice while reviewing and verifying the Pre Approval requests (OP/ IP) received from different departments to obtain authorizations as required by insurance companies dependent upon the plan coverage for all patients
- Handling the rejected pre authorization and get required justification from the treating doctor to resend it to Insurance Company and obtain the approval
- Ensure that the details of the Pre Authorization Requests are in line with the regulators' standards especially the claim adjudication Rules and Business Rules
- Prepares reports of daily activity as requested for management and assists management in month end reporting as requested
- Evaluate the Pre Approval requests from medical necessity for the requested service according to the medical data provided and accurately code the service description codes stated on the prior authorization requests, according to accepted medical coding rules, medical guidelines and policy's schedule of benefits
- Response to Insurance/ TPA queries and liaise with concerned department
- Experience in Medical Coding ICD, CPT, DRG and HCPCS
- Maintained high standards of personal conduct, contributing to a positive work environment.
- Increased operational efficiency by streamlining administrative processes.
Medical Coder (General Medicine & Dental)
Ahalia Medical Group
Abu Dhabi, UAE
08.2021 - 07.2023
- Accurately apply medical coding guidelines and regulations
- Handling claims submission, approval requests and evaluation of rejected claims
- Integrate medical coding and payment policy
- Responsible for checking eligibility of coverage of insurance
- Review patient charts and identify discrepancies in the medical documentation
- Assign CPT codes to descriptive procedures and medical services
- Assign ICD 10 CM codes for signs and symptoms and diseases
- Use correct codes for the physician office, clinics, hospital outpatient facilities, and ambulatory surgery centers
- Assign codes to a wide range of services, including evaluation and management, Anesthesia, Surgery, Radiology, Pathology, Medicine and Dental
- Integrate medical coding and payment policy changes into reimbursement
- Analyzes doctors' documentation to assure the appropriate evaluation and management (E&M) levels are assigned using the correct CPT code
- Provides feedback to doctors regarding coding errors or oversights
- Follow up and verify with GRE and Doctors on claims completion to ensure all procedures are updated
- Comply with all OSH and infection control policies, standards and procedures and cooperate with hospital management to comply those requirements
- Allocation of medical claims equally to the coding staff for on time completion and submission
- To coordinate and cooperate with other departments like reception and guiding them related to insurance coverage for smooth workflow
- Represent Ahalia Medical Group in Tasneef audits and support where required for technical and operational support to the audit team during and after the audit
Medical Coding Trainer
Skyline Education Services UAE
Abu Dhabi, UAE
01.2021 - 07.2021
- Prepares the students to pass the American Academy of Professional Coders (AAPC) certification exam and become a Certified Professional Coder (CPC) or Certified Professional Coder-Apprentice (CPC-A)
- Follows a learning process that first teaches concept, followed by practical application training
- Ensure student will participate in lectures, reading assignments, quizzes, chapter tests and practical application assignments to ensure a well-rounded learning experience
- Provide coaching to students in below areas
- The Business of Medicine, Review of Anatomy and Medical Terminology, Intro to ICD-10-CM, CPT and HCPCS Level II and Coding Guidelines and implementation
Medical Coding Instructor
Galaxy Institute
Abu Dhabi, UAE
01.2020 - 12.2020
- Prepares the students to pass the American Academy of Professional Coders (AAPC) certification exam and become a Certified Professional Coder (CPC) or Certified Professional Coder-Apprentice (CPC-A)
- Engaged students with hands-on activities resulting in increased interest in subject matter.
Education
Bachelor of Science - Zoology
Sree Narayana Women’s College
IndiaSkills
- Healthcare regulatory frameworks understanding
- Experience with cpt coding
- Knowledge transfer capability
- Experienced with surgical procedures
- Administrative duties efficiency
- Adapting to new guidelines
- Strong computer literacy
- HCPCS expertise
- Providing feedback to clinicians
- Healthcare policy understanding
- Handling workload pressure
- Regulatory compliance knowledge
- Fluency in medical transcription
- Clinical documentation interpretation
- Coding software proficiency
- ICD-10-CM coding proficiency
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Languages
English
Fluent
Malayalam
Native
Certification
Certified Professional Medical Coder (CPC)
AAPC Score – 80%
References
References available upon request.
Timeline
Approval Officer/ Medical Coder
Samaya Specialized Center
09.2023 - 03.2025
Medical Coder (General Medicine & Dental)
Ahalia Medical Group
08.2021 - 07.2023
Medical Coding Trainer
Skyline Education Services UAE
01.2021 - 07.2021
Medical Coding Instructor
Galaxy Institute
01.2020 - 12.2020
Bachelor of Science - Zoology
Sree Narayana Women’s College
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