PRAKASH TAMILSELVAN
Abu Dhabi,UAE
Summary
I am a highly skilled health information management professional with a proven track record of success in medical coding, auditing. Over the course of my 10-year career, I have developed a deep understanding of ICD-10-CM, CPT, and CMS Official Coding Guidelines, and have applied this knowledge to a variety of specialties, including Evaluation & Management coding, Emergency Department, Clinical Radiology Coding, Denial management Coding.
My expertise in these areas has enabled me to excel in my role as a medical coder, auditor. I am able to quickly and accurately assign diagnosis and procedure codes, perform coding audits, and provide effective training to other medical coders. I am also adept at reviewing medical records, identifying discrepancies, and recommending corrective actions.
Finally, I am highly proficient in MS Office, including Word, Excel, and PowerPoint. This proficiency has allowed me to create effective training materials and presentations, and to communicate effectively with colleagues and clients alike. Overall, I am a passionate and motivated health information management professional with a drive for excellence, and I am committed to providing the highest quality coding, auditing, and training services to my clients.
Overview
12
12
years of professional experience
2013
2013
years of post-secondary education
1
1
Certification
Work history
Medical Coder
NMC Speciality Hospital
ABU DHABI, UAE
2025.05 - Current
- Working as an OP coder and assign accurate ICD & CPT coding using ICD-10-CM Classification of diagnoses & procedure codes by reviewing and interpreting Electronic Medical Records and Physical case records based on Doctor's documentation.
- Pre(E)-authorization process (Outpatient) approval and coding.
- Check and analyse medical records for accuracy, adequacy, and consistency of documentation. Notify cases that have insufficient documentation or documentation discrepancy and inform doctors for documentation.
- Worked in a fast-paced facility coding department with multiple physicians specializing in outpatient and E&M Coding.
- Provides feedback and documentation advice to appropriate individual as trends are revealed.
- Ensure coded data accurately reflects service provided based on documentation.
- Review of errors, suggesting corrective action and making preventive actions to avoid same.
- Assisted in coordination of front office duties including checking eligibility and insurance billing.
- Having knowledge in Open jet, Daman& Thiqa dashboard and other insurance portal (ADNIC, Oman, Neuron, Pulse ...)
- Raise queries on clarification for client assistance and clear pended issues based on client response.
- Identify issues such as no physician signature on report, missing provider credentials, unacceptable providers, missing patient name on record, missing date of birth, illegible record etc. and communicate to supervisor for physician education.
Medical Coder & Auditor
Ventra Health care
Chennai
2024.04 - 2025.04
- Used ICD-10-CM and CPT coding to complete records.
- Utilized coding software to verify accuracy of diagnosis and procedure codes assigned to patient accounts.
- Reviewed medical records to assign codes according to classification systems.
- Analyzed medical documents to ensure accuracy of codes, modifiers, and units.
- Interpreted clinical documentation from providers for accurate assignment of diagnosis codes.
- Prepared and submitted claims to insurance companies and governmental agencies.
- Evaluated documentation to complete diagnosis coding and meet specificity requirements, supporting clinical indicators.
- Maintained a working knowledge of current ICD-10-CM and PCS guidelines and CPT code sets.
- Worked in high-volume medical coding and collections environment to maintain exceptional standards of excellence.
- Queried provider regarding missing, unclear, or conflicting health record documentation using approved templates.
- Performed minimum number of coding quality reviews consistent with established departmental goals.
- Resolved medical coding edits or billing item rejects in relation to code assignment.
- Reviewed medical records and identified relevant diagnoses and procedures for accurate coding of claims.
Medical Coder & Auditor
Access Health Care
Chennai
2021.04 - 2023.09
- Code outpatient medical records with ICD9CM, ICD-IO CM, CPT, and HCPCS Level II Coding, processing 120 charts daily and maintain 100% quality and accuracy.
- Expertise in Evaluation & Management, Urgent care Coding, Emergency department, Urgent care Coding, Multispecialty Denial management.
- Ensure all data are coded accurately and that the same reflects the service provided based on documentation.
- Performed Quality Analysis for Evaluation & Management Coders and educate them improve their quality.
- Auditing the claims coded by Evaluation & Management and Urgent care Coders, Multispecialty Denial management And provide the feedback and improve performance.
- Utilized coding software to verify accuracy of diagnosis and procedure codes assigned to patient accounts.
- Reviewed medical records to assign codes according to classification systems.
- Analyzed medical documents to ensure accuracy of codes, modifiers, and units.
- Interpreted clinical documentation from providers for accurate assignment of diagnosis codes.
Medical Coder & Auditor
Quintessence Business Solutions & Services
Chennai, Tamil Nadu
2017.10 - 2021.04
- Code outpatient medical records with ICD10 CM, ICD-IO CM, CPT, and HCPCS Level II Coding, processing 140 charts daily and maintain 100% quality and accuracy.
- Expertise in Evaluation & Management, Urgent care Coding, Emergency department, Urgent care Coding, Multispecialty Denial management.
- Ensure all data are coded accurately and that the same reflects the service provided based on documentation.
- Performed Quality Analysis for Evaluation & Management Coders and educate them improve their quality.
- Auditing the claims coded by Evaluation & Management and Urgent care Coders, Multispecialty Denial management And provide the feedback and improve performance.
- Generate QA reports on daily basis.
- Utilized coding software to verify accuracy of diagnosis and procedure codes assigned to patient accounts.
Medical Coder & Auditor
Technosoft Global Services Pvt.Ltd
Chennai, Tamil Nadu
2015.09 - 2016.09
- Code outpatient medical records with ICD9 CM, ICD-IO CM, CPT, and HCPCS Level II Coding, processing 150 charts daily and maintain 100% quality and accuracy.
- Expertise in Evaluation & Management, Urgent care Coding, Emergency department, Urgent care Coding, Multispecialty Denial management.
- Ensure all data are coded accurately and that the same reflects the service provided based on documentation.
- Performed Quality Analysis for Evaluation & Management Coders and educate them improve their quality.
- Auditing the claims coded by Evaluation & Management and Urgent care Coders, Multispecialty Denial management And provide the feedback and improve performance.
- Reviewed medical records to assign codes according to classification systems.
- Analyzed medical documents to ensure accuracy of codes, modifiers, and units.
- Utilized coding software to verify accuracy of diagnosis and procedure codes assigned to patient accounts.
Medical Coder
Omega Healthcare India Pvt Ltd
Trichy
2013.11 - 2015.01
- Code outpatient medical records with ICD9 CM, CPT, and HCPCS Level II Coding, processing 160 charts daily and maintain 100% quality and accuracy.
- Utilize 3M, Encoder Pro software, Coderyte 3M and Coding books for coding electronic and no electronic claims.
- Expertise in Evaluation & Management, Urgent care Coding, Emergency department, Urgent care Coding, Multispecialty Denial management.
- Ensure all data are coded accurately and that the same reflects the service provided based on documentation.
Education
M.Sc - Bioinformatics
Annamalai University
Chidambaram, TamilnaduSkills
- Procedure coding
- Urgent care
- Microsoft
- CPT coding
- Coding audit
- Denial management and Appeal
- Emergency Department coding
Certification
AHIMA- CCS
MEMBER ID-2793515
Timeline
Medical Coder
NMC Speciality Hospital
2025.05 - Current
Medical Coder & Auditor
Ventra Health care
2024.04 - 2025.04
Medical Coder & Auditor
Access Health Care
2021.04 - 2023.09
Medical Coder & Auditor
Quintessence Business Solutions & Services
2017.10 - 2021.04
Medical Coder & Auditor
Technosoft Global Services Pvt.Ltd
2015.09 - 2016.09
Medical Coder
Omega Healthcare India Pvt Ltd
2013.11 - 2015.01
M.Sc - Bioinformatics
Annamalai University