Medical Coding & Clinical Documentation AuditsConducts thorough audits for both inpatient and outpatient encounters, ensuring accuracy and compliance in medical coding and documentation.Audit Feedback & ReportingPrepares comprehensive audit feedback reports, presenting findings visually and verbally to the Knwbility team and external stakeholders, including physicians, medical coders, revenue cycle management professionals, and allied health teams.Clinical Documentation… Show more Medical Coding & Clinical Documentation AuditsConducts thorough audits for both inpatient and outpatient encounters, ensuring accuracy and compliance in medical coding and documentation.Audit Feedback & ReportingPrepares comprehensive audit feedback reports, presenting findings visually and verbally to the Knwbility team and external stakeholders, including physicians, medical coders, revenue cycle management professionals, and allied health teams.Clinical Documentation Improvement (CDI) TrainingDelivers targeted CDI training based on audit findings, enhancing documentation accuracy and quality across clinical teams.Course Development & Subject Matter ExpertiseCollaborates in developing medical coding and clinical documentation courses for Knwbility’s online learning management system (knwbility.com). Contributes expert feedback data and provides guidance in medical coding and revenue cycle management (RCM) processes.Case ManagementActively participated in case management processes to enhance patient care and ensure comprehensive service delivery, aligning clinical documentation with coding accuracy Show less

Supports Onsite/Offsite AuditsConducts audits for new projects in Abu Dhabi, Dubai, and KSA, focusing on Clinical Documentation, Compliance, and Due Diligence (e.g., Jawda Mock Audits).Quality and Viability AnalysisAnalyzes internal quality levels and external viability to develop service improvements and strategic enhancements.Internal Proficiency AuditsPerforms internal audits for proficiency on high-risk claims, high-frequency denials, and high-loss… Show more Supports Onsite/Offsite AuditsConducts audits for new projects in Abu Dhabi, Dubai, and KSA, focusing on Clinical Documentation, Compliance, and Due Diligence (e.g., Jawda Mock Audits).Quality and Viability AnalysisAnalyzes internal quality levels and external viability to develop service improvements and strategic enhancements.Internal Proficiency AuditsPerforms internal audits for proficiency on high-risk claims, high-frequency denials, and high-loss encounters.Trend-Based Project AuditsConducts specific project audits based on identified trends, providing analysis and feedback utilizing business intelligence tools.Coding and RCM Process ExpertiseProvides subject matter expertise in medical coding and revenue cycle management, assisting in the creation of feedback data. Show less

RCM Process OptimizationEnhances quality standards, proficiency, and returns within the Revenue Cycle Management (RCM) process, ensuring optimal financial performance.RCM Problem Identification & BenchmarkingDetects actual and potential issues within the RCM cycle, establishing benchmarks to drive process improvements and manage revenue leakages.Clinical Documentation Improvement (CDI) TrainingDelivers CDI training to physicians, supporting improved accuracy and… Show more RCM Process OptimizationEnhances quality standards, proficiency, and returns within the Revenue Cycle Management (RCM) process, ensuring optimal financial performance.RCM Problem Identification & BenchmarkingDetects actual and potential issues within the RCM cycle, establishing benchmarks to drive process improvements and manage revenue leakages.Clinical Documentation Improvement (CDI) TrainingDelivers CDI training to physicians, supporting improved accuracy and compliance in clinical documentation.LMS Course DevelopmentContributes expertise in developing Learning Management System (LMS) courses for medical coders and physicians, enhancing knowledge and compliance.Medical Audits & Denial ManagementConducts clinical coding audits, pre-Tasneef/mock audits, and manages denial resolutions, including resubmission and reconciliation efforts.Team LeadershipLeads a team of 15 certified medical coding auditors and coders, ensuring high-quality claims processing and resubmission for reconciliation. Experienced in resolving complex denial codes, such as MNEC-003, MNEC-004, MNEC-005, PRCE-002, PRCE-008, CLAI-012, CLAI-014, TIME-003, DUPL-002, NCOV-002, BENX-002, COPY-001, and ELIG-005.Coding & Auditing ExpertiseProficient in inpatient and outpatient coding, evaluation and management (E/M) coding, DRG validation, claim denial management, and medical auditing.RCM Audits & Stakeholder ReportingConducts RCM-related audits, providing comprehensive reports to stakeholders and clients for gap analysis and improvement across various facilities in the UAE. Show less

Accurate Coding and SequencingApplied precise coding and sequencing for inpatient charts using the International Classification of Diseases (ICD 9 &10) and Current Procedural Terminology (CPT) to ensure accurate representation of diagnoses and procedures.Medical Coding TrainingTrained subordinates in medical coding practices, enhancing team proficiency and adherence to coding standards.Inpatient DRG Audit ProcessConducted Diagnosis Related Group (DRG) audits for… Show more Accurate Coding and SequencingApplied precise coding and sequencing for inpatient charts using the International Classification of Diseases (ICD 9 &10) and Current Procedural Terminology (CPT) to ensure accurate representation of diagnoses and procedures.Medical Coding TrainingTrained subordinates in medical coding practices, enhancing team proficiency and adherence to coding standards.Inpatient DRG Audit ProcessConducted Diagnosis Related Group (DRG) audits for inpatient cases, ensuring compliance and accuracy in diagnosis and procedure coding.Dual-Coding Project ReviewPerformed dual-coding audits for inpatient charts in the ICD-9-CM and ICD-10-CM systems to support accurate transition and compliance. Show less

Accurate Coding AssignmentAssigned and sequenced the most accurate and descriptive codes from the International Classification of Diseases Ninth Revision, Clinical Modification (ICD) and Current Procedural Terminology (CPT) for diagnoses and procedures based on documented information.Comprehensive Record ReviewConducted thorough reviews of medical records to ensure the inclusion of all essential components, such as patient identification, signatures, dates, and other necessary… Show more Accurate Coding AssignmentAssigned and sequenced the most accurate and descriptive codes from the International Classification of Diseases Ninth Revision, Clinical Modification (ICD) and Current Procedural Terminology (CPT) for diagnoses and procedures based on documented information.Comprehensive Record ReviewConducted thorough reviews of medical records to ensure the inclusion of all essential components, such as patient identification, signatures, dates, and other necessary data relevant to the treatment provided.Anesthesia Business Consultants AccountDesignated to the Anesthesia Business Consultants account, utilizing a web-based encoding system to process an average of 70-80 charts per day.Training for SubordinatesProvided training to team members on the use of the web-based system and coding guidelines specific to the Anesthesia Business Consultants account.Documentation Consistency EvaluationEvaluated medical records for consistency and adequacy of documentation, ensuring that final diagnoses accurately reflect the care and treatment provided. Show less