Educational Qualification: Graduate degree in Commerce and Accounting.
Certification: CPC – P– Certified Professional Coder (American Academy of Professional Coders‐AAPC)
CMBS – Certified Medical Billing Specialist (Professional Healthcare Institute of America – PHIA).
Background: 19 years of U.S. Healthcare experience across Payer and Provider segments
Expertise in Provider contract configuration and Benefit configuration of various plans
Good exposure to Medicare Advantage and HMO Medicaid Enrollment
Subject Matter Expert in EDI transactions covering various HIPAA transaction sets
Expertise in ICD-10 Coding and Billing Audit
Data Analyst – Expertise in MS-SQL query and Excel.