Summary
Overview
Work history
Education
Skills
Languages
Custom
Timeline
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Srinithi Prasath (CPC)

Srinithi Prasath (CPC)

Sharjah,UAE

Summary

Accomplished professional with extensive expertise in healthcare revenue cycle management and payer/provider communications. Demonstrates proficiency in DRG approvals, internal audits, and medical data auditing, ensuring diagnostic accuracy and effective denial management. Skilled in data analysis using pivot tables and MS Excel, with a strong focus on process improvement and insurance reimbursement acumen. Adept at eclaim submissions and resubmissions, with a deep understanding of healthcare policy and market analysis. Known for resilience under pressure, collaborative teamwork, and time management efficiency. Career goals include advancing strategic roles within healthcare financial operations to drive innovation and optimise revenue processes.

Overview

5
5
years of professional experience
4
4
years of post-secondary education

Work history

Senior Medical coder and Auditor

NMC Healthcare (4+ years)
Sharjah, UAE
06.2021 - Current
  • Auditing the EMR Documentation by selecting random patient’s files
  • Monitors and follows up on prior authorization for outpatient/inpatient services.
  • Rejection analysis, management and coordination with responsible departments in developing collaborative strategies
  • Provide clinical expertise for managing insurance rejected claims with supportive medical justifications based on good clinical practice through support of physicians
  • Analyzes the claims prior to submission to Insurance Companies.
  • Manages complaints in coordination with the Supervisor/Department head Reconciling claims with insurance companies and coordination with Finance
  • Responsible for coding clinical diagnoses and procedures for OPD Records & DRG for IP visits
  • Determine insurance policy coverage, including, but not limited to, diagnosis, clinical procedures, investigations, medications, patient responsibility, authorization requirements etc.
  • Evaluated patient records for suitability, completeness, and correctness of health data
  • Performed audits specifically targeting and evaluating procedural diagnosis code selection.
  • Liaise with physicians, nurses and insurance department to assist them for proper documentation and reduction of rejections
  • Responsible for auditing claims for new employees
  • Reduced instances of denied claims by meticulously checking each bill's details before submission.
  • Maintained up-to-date knowledge about changing regulations, ensuring adherence to all legal requirements in the field of medical billing and coding.
  • Assured accuracy of medical codes for successful claim submissions.
  • Audited medical records to identify archive-ready files and discrepancies for resolution.

Medical Coder

Primera Medical technology
Bangalore, India
12.2019 - 01.2021
  • Code medical records with ICD-10-CM, CPT & HCPCS and maintain 98% accuracy with 100% productivity using Hospital Coding Guidelines
  • Utilize Epic, 3M software and input information into computerized patient record system for
  • CCI Edits in bundling and Unbundling procedures for a proper reimbursement from the insurance company (payors / third party) to the physicians
  • Handle variety of medical claims including Emergency Department Coding
  • Identify documentation issues and provide them to the clients for educating the physicians

Education

CPC- Certified Professional Coder -

AAPC

ICD -10-CM Certified coder - undefined

AAPC

B.tech (Bio-technology) - Medical science

Anna University
India
10.2010 - 07.2014

Skills

  • Payer / Provider communications
  • DRG Approvals and Internal Audits
  • Revenue cycle Management
  • Data Analysis (Pivot and MS excel)
  • Eclaim Submissions and Resubmissions
  • Denial Management
  • Process Improvement
  • Healthcare policy understanding
  • Diagnostic accuracy recognition
  • Collaborative teamwork
  • Strong analytical thinking
  • Insurance reimbursement acumen
  • Medical data auditing
  • Health data analysis
  • Resilience under pressure
  • Medical terminology expertise
  • Market analysis
  • Time management efficiency
  • Claim denial reasoning

Languages

English
Fluent
Hindi
Intermediate
Tamil
Proficient (C2)
Malayalam
Upper intermediate

Custom

I hereby declare that the information furnished above is true to the best of my knowledge.


                                                                                                Srinithi Prasath

Timeline

Senior Medical coder and Auditor

NMC Healthcare (4+ years)
06.2021 - Current

Medical Coder

Primera Medical technology
12.2019 - 01.2021

B.tech (Bio-technology) - Medical science

Anna University
10.2010 - 07.2014

ICD -10-CM Certified coder - undefined

AAPC

CPC- Certified Professional Coder -

AAPC

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Srinithi Prasath (CPC)