Ariful Islam Email and Phone Number

• Handling day-to-day data for 30 members, Delegate tasks and setdeadlines, Monitor team Performance and report on metrics.• Create an inspiring team environment with an opencommunication culture.• Listen to team members’ feedback and resolve any issues orconflicts, day to day clearing coder doubts & client query as wellwith justification.• Recognize high performance and reward accomplishmentsweekly as well as monthly basis.• Monitor team members' participation to ensure the training theyare being provided is being put into use, and to see if anyadditional training is needed. Doing random audit on team work to make sure met Client requirement Quality.• Develop a strategy the team will use to reach its goal.• Creating various, reporting data required by the manger andreport it.• Updating my knowledge with current update for ICD 10 CM. AHA Coding clinic Guidelines, Risk Adjustment (HCC).

• Managed medical records and documents, inputted informationinto internal database, retrieved and relayed information topractitioners• Responsible in reading and understanding diagnosis and interpretmedical information such as diseases or symptoms, and diagnosticdescriptions and procedures to accurately assign and sequencethe correct ICD 9 CM, ICD 10 CM, CPT and modifiers.• The diagnosis codes for each chronic or major medical conditionhave been captured and submitted within the permittedtimeframe with proper HCC Coding guidelines.• Knowledgeable in reading charts within EMR and HANDWRITTEN.• Review for clinical indicators and query providers to capture theseverity of illness of the patient.• Conducts claims audits/reviews, identifies opportunities forimproving individual member risk score accuracy and ensures riskadjustment clinical reviews are accurate, complete, specific, andappropriate

Review patients file and check patients eligibility about QID, Insurance ID cards etc. Supervise, manage and monitor claims submission and re submission to ensure accuracy and processing insurance claims in timely approach. Review and monitor denial reasons and discrepancies, processed claims to minimized revenue loss and maximize reimbursement. Processed claim forms, adjudicates for provision of deductibles, co-pays, co-insurance maximums and provider settlements. Entered claims data into system, reviewed and made sure that there is no omitted information, Entered claims into computer utilizing knowledge of ACHI, ICD 10 AM codes and medical terminology. Create a detailed summary report of filled claims for each month and keep tract of the payments, reconciliation, discrepancies and denials for reporting and filling purposes.

Duties include, but are not limited, to the following Responsible in reading and understanding diagnosis and interpret medical information such as diseases or symptoms, and diagnostic descriptions and procedures in order to accurately assign and sequence the correct ICD 9 CM, ICD 10 CM, CPT and modifiers. Knowledgeable of several coding systems including HCC, HQPAF SCREENING & HEDIS. Knowledgeable in reading charts within EMR and HANDWRITTEN.  Checks and analyzes medical records for accuracy, adequacy and consistency of documentation. Assigns appropriate codes for each diagnosis, operation and procedure based on the International Classification of Diseases and Procedures. Performs other duties as required.

■Prepare all necessary evaluation materials to successfully conduct ICD-10 CM to coders■Assess and evaluate training needs of individual coders■Instructs coders on the proper use and applications of ICD-10-CM to include the required level of specificity for clinical documentation to meet ICD-10 implementation■Modify training program as need to obtain desired group of coders

As medical coder- used to abstracting and coding (CPT-4 and ICD 9 CM) procedures and diagnosis from medical records. Verify medical record documentation requirements. (Indication, Techniques, summary & Impression also SOAP) Responsible for verifying that CPT-4, HCPCS MODIFIERS, LCD and ICD 9 CM coding used is correct.

Hyderabad as Patient Support Counsellor for period of 9 month; Call patients enrolled in patient support program.Create awareness/ counsel patients on disease management (Diabetes+ cholesterol).Provide advice/ suggestion/ diet recommendation.Collecting & maintaining data of individual patients.Adverse drug reaction reporting.