About Sithu Anirudhan
Sithu Anirudhan is based in Trivandrum, India. Sithu studied Bachelor of Science (Physics) at Sree Narayana College (1991-1994).
Talents
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Aptitude... among ... users in Trivandrum…among … users worldwide
Professional Path
Team Leader – Medical Billing & Coding
Sep-2017 To
Aug-2018
11 months
- Directing and coordinating the overall function of Medical Billing & Coding. Preparing detailed reports as per the request of clients. Identifying areas of under documentation, cloned and copy-paste medical records. Electronic signature and attestation requirements. Handling rejections coding related denials and bundling issues based on NCCI. Actively participate in all companywide initiatives
Senior Medical Coder – Multispecia
Medigain Health Pvt. Ltd., Chennai
Full Time
Mar-2017 To
Sep-2017
6 months
- Directing and coordinating the overall function of Medical Billing & Coding. Preparing detailed reports as per the request of clients. Identifying areas of under documentation, cloned and copy-paste medical records. Electronic signature and attestation requirements. Handling rejections coding related denials and bundling issues based on NCCI. Actively participate in all companywide initiativesAccuracy in assignment of ICD-10-CM, ICD-10-PCS, CPT & HCPCS code(s) as per patient’s medical record. Managing service delivery goals through daily client calls and maintaining good client relationship. Take a lead on client calls and share the minutes of meeting to client. Review and respond to coding questions that arise, research coding issues and update it. Reconcile clinical notes, patient encounter form, health information compliance with HIPAA rules. Provide coding and documentation advice as per the request of clients. Analyze coding to improve coding data accuracy for each insurance as pe
Assistant Manager – Medical Coding
Mar-2014 To
Mar-2017
3 years
- Oversee the Accuracy in assignment of code(s) as per patient’s medical record. Assure the assignment of accurate consistent codes by the medical coding unit by team meetings. Reconcile clinic notes, patient encounter form, health information compliance with HIPAA rules. Conduct periodical team meetings, discuss about previous week/month performance and provide feedback to employees on their performance. Plan, organize and monitor all coding operations. Provide coding and documentation advice to the coding unit, clinical and professional staff. Analyze billing to improve coding data accuracy for Medicare compliance reimbursement. Ensure coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse. Preparing the patient profile sheets with drop down codes in MRA for confirmation of the diagnosis at the time of appointment through daily appointment verification.. Analyzing Encountered diagnoses of members on corresponding date with their whole
Team Lead-Medical Coding, Claim Analysis & Credentialing
Feb-2008 To
Mar-2014
6 years 1 months
- Analyzing the Accuracy in assignment of ICD-9-CM, CPT & HCPCS code(s) and sequence diagnoses and procedures as per patient’s medical record. Assure the assignment of accurate consistent codes by the medical coding unit by team meetings. Reconcile clinic notes, patient encounter form and health information compliance with HIPAA rules. Provide coding and documentation advice to the coding unit, clinical and professional staff. Analyze billing to improve coding data accuracy for Medicare compliance reimbursement. Ensure coded data accurately reflects service provided, based on documentation, guarding against fraud and abuse. Analyzing Encountered diagnoses of members on the corresponding date with the whole charts for HCC diagnoses which missed for reporting earlier and enquire provider about the dropped down diagnoses existing or not for chronic cases Creating EDI file and sent claims through Gateway EDI in Organization Tax ID and corresponding PCPs Tax ID. Analyze the status of claims i
Team Lead - Medical Billing & Coding
Avida Mednet Pvt. Ltd., PMG, Trivandrum
Full Time
Jan-2006 To
Feb-2008
2 years 1 months
- Oversee daily Billing Department functions, including medical coding, charge entry, claims, payment posting, and reimbursement management. Examine patients encounter forms to verify diagnosis codes, and reconcile codes against services rendered. Accurately input procedure and diagnosis codes into billing software to generate invoices. Used electronic charge capture practices such as billing and account receivables (BAR) system and medical billing clearinghouse accounts to submit codes and invoices on time. Follow up on past due invoices and delinquent accounts to reduce number of unpaid and outstanding balances.
Medical Billing & Coding Executive
Nov-1999 To
Dec-2005
6 years 1 months
- Provide administrative support to physicians and interpret medical reports and data to assign ICD-9-CM codes; enter diagnosis codes and patient information into billing software. Follow and maintain currency on coding, sequencing, and procedures best practices and updates. Review and validate accuracy of charges, including dates of service, services provided, location, patient identification, and provider signature. Collected, posted, and managed patient account payments, and prepared and submitted claims forms to insurance companies and other third-party payers. Performed insurance verification, pre-certification, and pre-authorization. Entered procedure and diagnosis codes, and requisite patient information into billing software to streamline invoicing and account management; added modifiers, verified diagnosis, and coded narrative diagnosis. Responded to staff and client inquiries regarding CPT and diagnosis codes.
Qualifications
Sree Narayana College
Bachelor of Science Physics
1991-1994
60%
My Story
Motivated Medical Billing and Coding specialist with over 18 years of experience in Health Operation Management ([Medical Billing –RCM, Denial Management, Credentialing etc.] & Medical Coding [HCC, IP, ASC, OBS, OPS, GYN, E&M and ED]).
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