Subash Kumar Email & Phone Number

Team's Work Data management │IP, OP & DC – Pre-Auth | Day Case Billing, Coding & Resubmission │OP Billing, Coding & Resubmission │ IP Billing•Effectively doing weekly audit on Pre-Auth(IP,OP & DC) & Re-submission Claims for educating & monitoring quality, guiding team in special cases.•Responsible for bi-monthly clearance of OP Coding, Resubmission & Pre-Auth.•Initiated and guided team to create Master Document on Insurance wise Coverage & Pre-Approval guidelines & helped in incorporating the same with EMR system.•Responsible for reviewing & replying for Insurance audit reports & Part of Tasneef audit preparations.•Initiated and conducted training to improve the technical, insurance and medical knowledge compliance of team members with supervisor interest.•Often Conducting Education Sessions with Doctors - department wise and individually ,discussing Coding & Documentation Tips to Improve based on recent findings, Feedback based from Rejection analysis & recent audits•Educating Coding & Billing team about Denial observation and process enhancement.•Claim denial analysis - based on Medical Necessity, pricing, crosschecking ICD's and CPT's coded and verifying Coverage based on SOB, there identifying the cause of rejection, Resubmitting to insurance in proper way or accept rejection and continuously contributing to enhancing overall process based on findings ,as well as identifying frauds and irregularities. •Meeting the resubmission productivity target on a daily basis efficiently with accuracy,•Participated in developing rule engines and the billing system by providing new ideas and proposal to enhance the process (in New EMR implementation process).•Provided all the needed support as advised by the supervisor based on the business need like Regular Educational Sessions on Rejection analysis findings to Doctors &other RCM departments, Coding refresher Classes for Doctors, Nurses, Physiotherapists & orientation for new medical Staffs.

Listed skills include Ultrasound, Biomedical Engineering, Healthcare, Radiology, and 17 others.