Biplab Debnath, Cpc, Caimc Email & Phone Number

Bengaluru, Karnataka, India

• Collaborates with the CST team and Coding team to identify coding education opportunities, coding issues and compliance issues.
• Address identified issues with client and provide education with supporting documentation and/or training materials.
• Assist clients with coding process issues and makes recommendations for best practice process or policy.
• Meets with Coding team to review coding compliance concerns as related to National Coverage Determinations and Local Coverage Determinations and initiates staff education on such matters as necessary.
• Implementation of new clients to include the completion of all on boarding project tasks within the timeline. Meet with Coding team to review client specific instructions and guidelines. Obtain clarification from.
• Identify coding denial trends and make system updates as needed. (Creates Rule Engine rules, mandatory diagnosis rules, explosion codes etc.).

Bengaluru, Karnataka, India

• Handling a team of 20 members, including day-to-day work allocations and monitoring performance.
• Review daily quality reports to identify any gaps and making sure to address it for better performance.
• Conducting daily team briefings/huddles to clearly discuss daily workflow and delivering responsibilities.
• Participate in monthly 1-1 discussions to identify individual challenges and address the same on time.
• Preparing daily, weekly, and monthly reports from the Practice Management Software using MS-Excel.
• Establishing a strong relationship with line managers to identify process gaps, trends and patterns.

Ahmedabad, Gujarat, India

• Maintains day-to-day activities of coding and billing staffs, follow-ups and monitoring team performance.
• Collaborated with cross-functional teams to ensure successful project milestones.
• Works with leaderships to standardize work flows and establish/improve processes.
• Listen to each team member's feedback and resolve any issues or conflicts at work place.
• Evaluate effectiveness of the process, implement changes to policies and procedures (SOP's).
• Participated in hiring and training for new employees and assigning shadow.

Ahmedabad Area, India

• Responsible for charge posting, patient eligibility and benefit verifications, referral and authorization.
• Posting insurance payment and cash payment, including ERA/EOB, Check, and CC payments.
• Responsible for daily claim batch reconciliation and rejections analysis, corrections/re-submissions.
• AR follow-up on aged accounts including Appeal and Reconsideration for pended claims.
• Refer coding guidelines: CCI edits, diagnosis exclusion, LCD, NCD guidelines to ensure proper coding.
• Experienced with major insurance companies: MCR, MCD coding/billing policies to ensure compliance.

Ahmedabad Area, India

• Responsible for day-to-day charge capture and claim creation by abstracting CPT, ICD-10, and HCPCS.
• Responsible for member eligibility and benefits verification to estimate cost for service to be rendered.
• Responsible for requesting prior authorization by calling utilization department prior to the service.
• Charge posting, credit balance reconciliation and financial clearance for each patient account activities.
• Claim submission through clearinghouse including tracking of claim batches and rejections analysis.

Gift City, Gandhinagar

• CPT, ICD-10, and HCPCS coding including CCI edits check and following LCD and NCD guidelines.
• Responsible to refer State and Federal insurance guidelines and procedures for correct coding.
• Patient demographic entry, eligibility and benefits verification including Copay, Co-ins and Deductible.
• Responsible for claim batch reconciliation and cross audit for error check and corrections.