Wiki CMRS Certified and CPC certified

[chandrasheker]

Chandra Sheker Boreda
Email:chandra4u86@yahoo.comchandra4u86@yahoo.com
Phone #: +91 9999722091
U 52, 45/46
DLF PHASE III
GURGAON
HARYANA, 122002
INDIA

OBJECTIVE:

To utilize my strong and versatile experience in Medical Coding and Medical Billing and to share my expertise with an organization that can provide opportunities to enhance my skills and further develop qualities of higher leadership.
EDUCATION

2002-2005 Bachelor of commerce Kalinga University,India
1991-1993 Board of Intermediate (Andhra Pradesh) in CEC
WORK EXPERIENCE

Working in GENPACT, India as a Consultant and Subject Matter Expert in the Medical Coding & Billing Departments from 14th May 2007 to till date
Worked in InfoGenex Technologies Pvt Ltd as Medical Coding & Billing Specialist from 1st February 2007 to 10th May 2007
Worked in Talluri Technologies Pvt Ltd as a Medical Coding & Billing Specialist from 2003 October to 31st January 2007
Worked in RainBow Hormones & Histopathology center, Hyderabad, India as Sr.Executive from May 2000 to September 2003

Worked in Apollo Diagnostics and Radiology Lab service, Hyderabad, India as Sr.Executive from May 1997 to 2000 March

ONSITE EXPERIENCE

Went to the United States of America for on job training and successfully completed.


Designation in Genpact: Consultant (Band 4b)



Job Profile in Genpact:
 Training new hires.
 Refresher trainings.
 Review and respond all client queries. Maintain its record, RCA, action items, and implementation of action items.
 Conducting all content-related and technical meeting. Also part of decisions on new updates etc.
 Sharing new updates and other findings (Query etc.) with the team.
 Taking day to day updates from the client and provide training to the associates.
 SOP and other tracker update.
 Taking the Knowledge Assessment Tests (KAT) on monthly basis for the team to deliver knowledge excellence and make all team members updated on the process. Sharing the results with team and leadership.
 Internal query resolution from the editors both IGX and Onshore team.
 Performance improvement program for editors with the help of mentors based on error analysis.
 My primary responsibility is to ensure 100% quality on medical bill review done by the team.
 As being Subject Matter Expert and Process trainer, I will provide training on the Medical Bill Review Updates.
 Identifies the coding relationships/edits using CCI Editor.
 Promoted as a trainer for the new process.
 Job profile is to review the bills before doing the payment made by the insurance.
 Delivering the bills with in the TAT time.
 Created training modules for Revenue Cycle Management (RCM) Process.
 Created Standard Operating Procedure (SOP) for the process to follow the same working methodology by all the team members. And updating the SOP continuously as per client requirement.
 Trained more than 20 Associates for the Revenue Cycle Management (RCM) Process.

Job Profile in Talluri Technologies Pvt Ltd
Coding
 Specialties:
1. Surgery: Podiatry, Injections, Muskuloskeletal, Integumentary, GI
2. Radiology: Diagnostic radiology, Diagnostic Ultrasound, etc.
3. E/M: Cardilogy, Gastroenterology, Outpatient, Inpatient, Nursing Home visits, Emergency care.


Job Profile:
 My primary responsibility is to code medical charts for out- patients through the understanding of medical terminology, AMA guidelines, anatomy, physiology and procedures and assigning the appropriate CPT, ICD-9-CM, HCPCS and special access codes based on medical documentation in a timely and accurate manner.
 Associate the diagnosis codes to the appropriate procedure codes (CPT) and sequence the codes in such a way as to ensure proper reimbursement.
 Determining the provider and keying the information into the system and accurately apply, differences in coding requirements for various payers, clients and state programs.
 Participating in seminars to monitor and improve coding related changes.
 Helped billing staff rectify insurance denials by educating the staff on coding issues.
 Assisted Office Manager with the auditing of E&M medical records to ensure the documentation supported the level of service billed.
 Responsible for troubleshooting coding issues before electronic claims submission.
 Managing and Auditing of monthly reports
 Quality assurance for all files on hand.



Certification:
 CMRS Certified (Certified Medical Reimbursement Specialist) from American Medical Billing Association.
 CPC (Certified professional coder) From American Academy of Professional Coders.
 HIPAA(health insurance portability and accountability act ) and certified
 Successfully completed training on Medical Terminology and certified.
 Successfully completed HIPPA Certification from INGENIX (US)
 Successfully completed Medical Necessity certification from CMS (Center for Medicaid and Medicare services)
 Successfully completed CMS Form 1500 Certification from CMS (Center for Medicaid and Medicare services).
 Successfully completed Medicare Preventive Services: part 1 Adult Immunizations Certification from CMS (Center for Medicaid and Medicare services).

Medical Billing Responsibilities
 My responsibility is to do a 100% accuracy check on all the entries made on a daily basis to avoid errors. We maintain a 100% accuracy rate.
 Responsibility of transmission of medical claims to the insurance companies.
 Handle the clearing house denials.
 Claim submission and managing documents and records.
 Experience in charge entries, payment postings, handling denials and rejections.
 Claims management preceding the transmission of claims on a daily basis.
 Handled the edits for all the clients, modified those claims and retransmitted respectively.
 Experience in Accounts Receivables for one year.
 Handling calls from insurance agents as well as the clients directly.
 Analyzing denials and rejections before modifying and resubmitting the claims.




Areas of Expertise:
 Good communication and analytical skills.
 Time management skills and good leadership qualities and ability to work as a team and achieve the set objectives.
 Posses a good blend of academic and practical knowledge to work as medical coder.
 Pleasing and pleasant personality.
 Hard working.
Trainings Completed:
 Successfully Completed New Manager Induction Program (NMI).
 Green Belt (GB) Trained and tested.
 Lean Trained and tested.
 Completed training on Conference Call Essentials and Certified.
Personal Profile:

Name : B.chandrasheker.
Father’s name : B.kistaiah
DOB : 01-12-1974.
Martial status : Married

Place: GURGAON B. Chandra Sheker