Summary
Overview
Work History
Education
Skills
PROFESSIONAL TRAINING
Certification
Personal Information
Languages
Affiliations
References
Timeline
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NISHABEEGOM S

NISHABEEGOM S

Kollam

Summary

AAPC-certified Medical Coder with over five years of expertise in medical coding and healthcare documentation. Holds an MSc in Biomedical Instrumentation and a Postgraduate Diploma in Computer Application. Proficient in ICD-10, CPT, and HCPCS coding, with a strong track record in claims processing and compliance with UAE healthcare regulations. Experienced in EHR systems and committed to accuracy in coding and documentation, with additional teaching experience in Medical Laboratory Technology.

Overview

20
20
years of professional experience
1
1
Certification

Work History

Medical Coding & Insurance Expertise

Revenue Care RCM
Abu Dhabi
06.2024 - Current
  • Company Overview: Medical Coding & Insurance Expertise
  • Experienced in end-to-end claim processing, including submission, resubmission, eligibility verification, insurance approvals, reconciliation, and denial management.
  • Proficient in SHADE software and familiar with Amthal.
  • Well versed in HAAD adjudication rules, RCM flow charts, and outpatient insurance approval limits and policies.
  • Demonstrates strong knowledge of general coding guidelines, E&M outpatient coding, and specialty specific standards for telemedicine, dermatology, dental, gynecology, physiotherapy, obstetrics, occupational medicine, and per diem time-based coding.
  • Skilled in applying Daman lab coding guidelines, appropriate indications, and drug list coding.
  • Experienced in handling cash file coding, Tasneef audits, and using modifiers accurately.
  • Competent in preparing practice charts and interpreting denial codes such as MNEC003 and CLAI001.
  • Knowledgeable in dental procedure and diagnosis coding, per diem services, and insurance processes with Daman, ADNIC, NAS, Nextcare, Al fardan Exchange.
  • Medical Coding & Insurance Expertise

Medical Coder

Assure Healthcare
Puduchery
08.2024 - 10.2024
  • Conducted comprehensive medical record reviews to assign accurate ICD-10-CM codes based on HCC guidelines.
  • Ensured coding accuracy and documentation integrity in compliance with CMS standards.
  • Utilized advanced coding software and EHR systems to enhance workflow efficiency.
  • Maintained high productivity and coding quality while working independently in a remote setting.
  • Applied knowledge of risk adjustment models for precise patient risk stratification and reimbursement.
  • Collaborated with physicians, auditors, and clinical teams to resolve coding discrepancies.
  • Monitored industry updates and coding guidelines to uphold compliant practices.

Assistant in Operations and Communication Dept

Al Fardan Exchange
Abu Dhabi
12.2009 - 10.2011
  • Processed remittances online with major banks, managing diverse transactions efficiently.
  • Cultivated positive relationships with internal customers through effective communication strategies.
  • Served as liaison to resolve transaction issues and prepare confirmations and funding advices.
  • Executed amendments, cancellations, and stop payments while advising banks on funding needs.
  • Maintained and updated files, databases, and records, conducting data analysis for internal reports.
  • Facilitated outward remittances via telex, fax, and email to ensure timely processing.

Lecturer in MLT

Mahatma Gandhi, School of Medical Education
Kottayam
05.2005 - 11.2009
  • Delivered in-depth lectures on medical and laboratory equipment, focusing on biophysics principles.
  • Covered the physical principles of laboratory instruments, measurement techniques, and their application in diagnostics and research.
  • Offered hands-on training, helping students operate, calibrate, and maintain equipment, and apply biophysics concepts to real-world scenarios.
  • Evaluated student projects and assignments, providing feedback to integrate theoretical knowledge with practical skills.
  • Ensured rigorous assessments aligned with course objectives, enhancing students' understanding of biophysics in medical laboratory work.
  • Contributed to shaping students' readiness for professional roles in medical laboratories.

Education

Master of Science - Bio-Medical Instrumentation

School of Medical Education
Kottayam, Kerala, India
01.2003

Bachelor of Science - Physics

Kerala University
India
01.2001

Skills

  • Medical billing and coding
  • ICD-10 and CPT proficiency
  • CPT modifier application
  • EHR proficiency
  • HIPAA compliance
  • Denial management
  • Insurance verification
  • Claims management systems
  • Clinical documentation review
  • Diagnostic coding accuracy
  • Quality assurance checks
  • Insurance claims analysis
  • Workflow optimization
  • Time management
  • Critical thinking
  • Effective communication
  • Team collaboration
  • Adaptability
  • Leadership

PROFESSIONAL TRAINING

  • Bio Medical Engineer, Meenakshi Mission Hospital, Handled technical and operational activities related to the installation of biomedical equipment, ensuring proper setup, calibration, and functionality in accordance with hospital protocols., Managed the procurement process for biomedical equipment and accessories, including vendor coordination and endorsement of payments to guarantee timely and accurate acquisition., Maintained and regularly updated the complete inventory of medical equipment installed in the hospital, ensuring accurate tracking, compliance, and asset visibility., Performed preventive maintenance tasks, including routine safety inspections, equipment calibration, and servicing, to ensure optimal performance and adherence to health and safety standards., Collaborated with service personnel from various biomedical equipment suppliers to facilitate timely maintenance, troubleshooting, and repair operations., Additionally, conducted structured training sessions for hospital staff, educating them on the safe, effective use of biomedical equipment.
  • Bio Medical Engineer, KIMS Hospital, Trivandrum, Managed the installation of biomedical equipment, handling all technical and operational aspects to ensure proper setup, configuration, and functionality., Oversaw the procurement of biomedical devices and accessories, coordinating with vendors and endorsing payments to ensure timely and accurate acquisition of equipment., Maintained and regularly updated the inventory of all medical equipment installed in the hospital, ensuring precise recordkeeping and efficient asset tracking., Performed essential equipment maintenance tasks including safety inspections, routine calibrations, and servicing to uphold reliability, functionality, and compliance with safety standards., Coordinated closely with service personnel from various medical equipment companies to schedule and facilitate timely maintenance, repairs, and support activities, ensuring uninterrupted operation of critical medical systems.

Certification

  • CPC Certified Medical Coder, AAPC, Does not expire
  • Post Graduate Diploma in Computer Application, Institute of Human Resources Development (IHRD), Does not expire

Personal Information

  • Total Experience: 7 years 7 months
  • Date of Birth: 01/10/81
  • Nationality: Indian
  • Marital Status: Married

Languages

Malayalam
First Language
English
Upper Intermediate (B2)
B2
Hindi
Upper Intermediate (B2)
B2
Tamil
Intermediate (B1)
B1
Arabic
Upper Intermediate (B2)
B2

Affiliations

Reading

Listening to music

Internet Surfing

References

References available upon request.

Timeline

Medical Coder

Assure Healthcare
08.2024 - 10.2024

Medical Coding & Insurance Expertise

Revenue Care RCM
06.2024 - Current

Assistant in Operations and Communication Dept

Al Fardan Exchange
12.2009 - 10.2011

Lecturer in MLT

Mahatma Gandhi, School of Medical Education
05.2005 - 11.2009

Master of Science - Bio-Medical Instrumentation

School of Medical Education

Bachelor of Science - Physics

Kerala University
NISHABEEGOM S