Research to support payment accuracy based on Correct Coding Guidelines.Manage the integrity of the Medicaid Payment Policy Library and integrated claims management and ensure that it is accurate and up-to-date.Help the clients develop a comprehensive, rule driven & defensive payment policy that allows the client to pay claims accurately using research skills, coding expertise and industry knowledge of constantly updating healthcare payment policy library due to changing federal & state regulatory & clinical guidelinesResolution of research requests created by clients with respect to claim denials & providing insights based on clinical and coding review of claims to assure that accurate coding guidelines were used for basis of payment.Maintaining new rules(algorithms) based on Centre for Medicare and Medicaid Services Guidelines (CMS), State medicaid Guidelines.

Supervised radiology & diagnostic imaging procedures of department with staff count over 70 & daily footfall of over 500.Maintained safety standards as they relate to radioactivity by complying to guidelines provided by Atomic Energy Regulatory Board (AERB), Pre-Conception and Pre-Natal Diagnostic Techniques Act (PCPNDT) and keep staff and patients within safety levels by controlling and recording radium levels.Leading & reinforcing National Accreditation Board for Hospitals and Healthcare Providers (NABH) compliance  of the Department of Radiology. Successfully lead NABH audits.Handled the human resource aspect of radiology department,including selection,training,regulating, monitoring & leading staff members and advising their compensation.Ensured adherence to all appropriate radiology standards of operation & patient care standards, including Patient Feedback mechanism, Turnaround Time, Waiting time management.Implementing clinical systems like correlation of diagnostics reports, peer review & intimation of critical reporting.Troubleshoot any technical issues by coordinating with biomedical team and keeping follow-ups and ensured regular maintenance of radiology equipment.Collect data throughout fiscal year and prepare analysis sheets.Managing outsourced services, their agreements & MOU with legal team, sanctioning of bills & receipts

Handled core clinical operations of departments like Operation Theatre, Endoscopy, Cath Lab, CSSD which includes but not limited to:Interdepartmental coordination for smooth outcome of procedures/surgeries/patient care.Statutory & legal compliances.Scheduling surgeries/procedures in OT, Cath lab and endoscopy.Preparing schedule of surgeons/doctors/anesthetists of respective departments and arrangement ofvisiting surgeons/anesthetist as & when needed.Reinforcing system of planned cases and coordinate unplanned/emergency cases smoothly.Leading Quality Improvement Project (QIP) of planned, unplanned & emergency surgeries, capture and analyze waiting time and cause of delay.Ensuring SOP compliance in departments & assisting quality team in ensuring NABH standards.Leave management of staff & manpower allocation to ensure efficient utilization of human resource.Identifying training needs of employee, planning L&D programs, performance appraisal of staff along with HR.Liaisoning with vendors for outsourced services

Handled general & clinical administration in allocated branch of the organization. Responsible for managing patient complaints, feedbacks & own timely delivery of every service deliverables; Responsible for periodic training to staff to give quality care to patient; Ensuring good productivity from subordinate staff; Ensure Availability of staff and Doctors, Functioning of Equipment, Cleanliness and Hygiene, Availability of supplies, Sterility in Operating rooms etc. ; implementation of correct clinical & legal documentation of surgeries, ensuring proper scheduling; Monitoring TPA approvals & financial gaps, keep surgical/opd analytical data up-to-date; Controlling usage of essential consumables.

Worked and completed research and analysis on following Projects: Turnaround Time & Quality Indicator Of A&E Safe Surgical checklist Compliance in OTImplementation of Medication Safety Drive

CHL Hospitals is a 225-bedded Multi Specialty Critical Care Hospital located in Indore, Madhya Pradesh, (India) and has premium connectivity with the entire India. The hospital has gained widespread recognition being the first fully equipped center of international standard for Cardiac Interventions and Surgeries in the state. The hospital also enjoys the reputation of being the first to perform Coronary Bypass Surgeries, Coronary Angioplasty and other Catheter based interventions in Indore with a record of highest numbers in central India.Projects done during the internship:1.General Administration2.Assisting the quality assurance executive in NABH Accreditation Manual Documentation.

Undergone Compulsory Rotatory Internship, participate as a member of a multi-disciplinary team in the provision of medical care to patients in various departments of the hospital along with the reporting, coordination.