Arivu Dineshkumar Email & Phone Number

Ajman, United Arab Emirates

𝑲𝒆𝒚 𝑹𝒆𝒔𝒑𝒐𝒏𝒔𝒊𝒃𝒊𝒍𝒊𝒕𝒊𝒆𝒔 –❖ Spearheading and overseeing the Resubmission team, driving exceptional performance and collaboration while ensuring accurate and timely completion of Resubmission tasks❖ Pioneering intricate claim denial analysis, delving into granular details encompassing Medical Necessity, pricing intricacies, and meticulous crosschecking of ICD's and CPT's, while astutely verifying Insurance companies' Coverage as per their Statement of Benefits (SOB). ❖ Masterfully identifying the underlying causes of claim rejections, orchestrating methodical resubmission strategies bolstered by compelling supportive documents, irrefutable Medical justification, and impeccable codes, ensuring maximum success in obtaining rightful approvals from Insurance providers. ❖ Exemplifying a trailblazing commitment to knowledge sharing and capacity building, conducting regular Training Sessions to disseminate Rejection analysis findings, delivering dynamic Coding refresher Classes to empower Doctors, Nurses, and Physiotherapists, and orchestrating comprehensive orientation programs for new medical Staffs. ❖ Championing the charge in reviewing and artfully responding to intricate Insurance audit reports and seamlessly navigating high-stakes meetings with Insurance representatives, consistently upholding uncompromising standards of compliance and accuracy. ❖ Deftly prioritizing tasks and managing multiple responsibilities within the resubmission and sign-off team, thereby ensuring optimal efficiency and fostering an environment of excellence in claim resubmission operations. ❖ Spearheading process improvement initiatives by implementing innovative strategies and technologies to streamline the resubmission process, resulting in enhanced efficiency, reduced turnaround time, and increased claim reimbursement rates.

Ajman

❖ Under direction, supervises the work of staff who review, interpret, code and abstract medical records information according to standard classification systems.❖ Performs the most advanced medical records coding and abstraction duties.❖ Performs data quality reviews and prepares complex reports as required;and performs other related duties as assigned.

Ajman, United Arab Emirates

𝑲𝒆𝒚 𝑹𝒆𝒔𝒑𝒐𝒏𝒔𝒊𝒃𝒊𝒍𝒊𝒕𝒊𝒆𝒔 –❖ Demonstrated expertise in coding and abstracting diagnosis and procedure information from patient medical records in strict adherence to the American Hospital Association (AHA) ICD-10-CM/PCS and American Medical Association (AMA) CPT-4 coding guidelines. Additionally, effectively utilized the 3M coding system to verify and assign codes while proficiently performing Shadow IR-DRG coding. ❖ Ensured the accuracy of coded medical records and diligently worked towards completing them within the specified turnaround time (TAT). Provided valuable feedback to coders, clinicians, and other stakeholders to support the timely completion of medical records.❖ Identified any incomplete documentation in the medical records. ❖ Developed effective physician queries to obtain missing documentation or seek clarification, enabling the accurate and comprehensive completion of the coding process. Exhibited a strong understanding of reconciliation processes, specifically focusing on working with rejection cases related to medical indication and coding insufficiency.❖ Implemented best practices and followed UHDDS (Uniform Hospital Discharge Data Set) and CMS (Centers for Medicare and Medicaid Services) guidelines and regulations throughout the coding process. ❖ Participated in continuous professional development activities to stay updated with the latest coding guidelines, regulations, and industry advancements. ❖ Demonstrated a commitment to enhancing skills and knowledge in the field of medical coding. ❖ Collaborated effectively with multidisciplinary teams, including clinicians, coders, and other healthcare professionals, to obtain necessary information and ensure accurate coding of medical records. ❖ Maintained confidentiality and data security in handling sensitive patient information during the coding process. Adhered to ethical standards and protected patient privacy in accordance with relevant laws and regulations.

𝑲𝒆𝒚 𝑹𝒆𝒔𝒑𝒐𝒏𝒔𝒊𝒃𝒊𝒍𝒊𝒕𝒊𝒆𝒔 –❖ Collaborated with various departments to optimize reimbursement processes, ensuring efficient charge capture and reducing instances of late charges. ❖ Provided valuable feedback to coders, enabling continuous improvement in coding practices. ❖ Abstracted pertinent clinical and demographic information from medical records, utilizing this information to accurately assign ICD-10 CM and CPT-4 codes in strict adherence to coding and client guidelines. ❖ Employed standard coding guidelines from the Centers for Medicare and Medicaid Services (CMS) , including ICD-9-CM/ICD-10-CM and American Medical Association (AMA) CPT-4 coding guidelines, as well as adhering to UHDDS and CMS guidelines and regulations. Utilized the 3M Encoder to verify and assign AHA ICD-9-CM/ICD-10-CM and AMA CPT-4 codes. ❖ Actively collaborated with department management on coding interface, development, enhancements, and changes, actively contributing to the planning and implementation of these functions. ❖ Successfully maintained daily productivity levels and turnaround times, diligently adhering to the Department's Performance Improvement plan. ❖ Participated in ongoing professional development activities, including attending training sessions and staying updated with the latest coding guidelines, regulations, and industry best practices. Assisted in the review and analysis of coding-related issues, providing insights and recommendations to improve coding accuracy and efficiency.❖ Contributed to the identification and implementation of process improvements to enhance overall coding operations.