Dr. SANDEEP KATARIA, CCA AHIMA, CPC®, ICD-10-CM, certified by AAPC
Al-noor accommodation al-Almeria, al-jimi, al-ain, post box-14444, Abu Dhabi
Mobile: 0502810361, 0526104344, E-Mail: [email protected]
Technically-adept Healthcare professional with almost 12+ years of experience in medical coding providing business solutions that improve accuracy, drive growth, and maximize revenue.
Objective: Seeking a position of Manager/Team Leader in Healthcare sector
CAREER PROFILE
Trained in End-to-End Revenue Cycle Management from Lighthouse MD Ingenix, Providence, Rhode Island, USA. Instrumental in smooth transition of cpt and diagnosis Medial Coding.
Sound experience in the Healthcare sector ranging from Clinical Care like Surgery, Evaluation & management, Radiology, Anaesthesia to Administrative responsibility like medical Coding to Revenue Cycle Management.
Expertise in utilizing ICD-10-CM, CPT-4, and HCPCS level II with excellent proficiency in physician, outpatient/inpatient, and ambulance coding. Expertise in E&M for all specialities
Demonstrated ability to function effectively as a team player as well as working independently to achieve objectives.
Developed processes to ensure timely completion of interdepartmental functions, which included timely submission activity sequence, duration estimates, and schedule development and control.
Self-motivated, efficient, resourceful and reliable under pressure.
Excellent communication and interpersonal skills.
Confident and poised in interactions with individuals at all levels.
Detail oriented and resourceful in the completion of tasks with ability to multi-task effectively.
Possess strong problem resolution skills.
Dedicated individual achieving a reputation for consistently going beyond what is required.
Actively involved in physician, nurses and other paramedical staff training time to time.

Core Competencies
Defining Business solutions | Cpt, diagnosis, hcpcs, procedures Coding in all specialities | Defining processes & Policies | Coding research / Review| Auditing
Mentoring | Team Dynamics | Leadership skills | Excellent problem solving | Analytical ability with focused approach | Relationship management & advocacy | Benchmarking & standardization of the internal processes | Adapting the best international practices to local environment
PROFESSIONAL EXPERIENCE
RCM Administrator (Revenue Cycle Management) (Oct 2011- Onwards)
Mediclinic Hospitals (formerly AL-NOOR HOSPITAL, AL-AIN Abu dhabi UAE
Assigning accurate CPT, ICD 10CM, HCPCS, E&M Codes to outpatient (clinic, radiology, lab, and all departmental specialities) Expertise in nuclear medicine department.
The three key components with emphasis on MDM and other subjective aspects of the Documentation Guidelines Coding per NCCI, ICD-10-CM,CPT and both the 1995 and 1997 Documentation Guidelines The three key components with emphasis on MDM and other subjective aspects of the Documentation Guidelines Risk assessment, including (but not limited to) the ability to benchmark, identity problematic situations and missed billing opportunities. Defined and refined existing processes and policies through research work in response to coding review cases with expertise in ICD-10CM diagnosis coding
Seeks clarification from provider for appropriate code assignment when insufficient documentation of procedures, diagnoses and any deficiency in clinical documentation which includes (doctor, nurses and allied paramedical responsible for clinical documentation.
Maintaining of logs and productivity records daily.
Spearheading in Production, Data Management, Auditing, Training, Diagnosis and Procedural Coding, data consolidation/analysis for Process etc.
Be able to work independently in a fast paced environment with the ability to meet deadline.
Abstracts information into company Billing, Insurance department..
Ability to comprehend whether secondary diagnosis and/or procedures are codeable.
Fulfil additional performance responsibilities, as assigned, accurately and in a timely manner.
Experience in DRG assignment.
Recently gained training as a member of resubmission team for handling denial cases.
Providing training to newly joined subordinates about software, policy, procedures, guidelines related to RCM department.
Sound knowledge of coding software’s (3M, ERP, HIS, HIM, SAP and other coding related software)
Recently gained training in CDI (Clinical documentation improvement), expertise in reviewing outpatient documentation for accuracy to support coding, quality measures, and clinical requirements. Provide feedback to Physician, nurses and allied paramedical staff to improve clinical documentation and facilitate ongoing documentation improvement to meet all requirements of the medical record.
Business Analyst (Dec 2009-Oct 2011)
GENPACT, GURGAON
Responsibilities:
Accountable for Revenue Cycle Management for an US client - Ingenix (a UHG Subsidiary) on behalf of Genpact India.
Spearheading in Production, Data Management, Auditing, Training, Diagnosis and Procedural Coding, data consolidation/analysis for Process etc.
Ensure excellent documentation on business requirements like analyze reports and establish the processes.
Perform administrative duties and oversee operational aspects like updating guidelines regularly.
Define and refine existing processes and policies in response to external and internal changes.
Assist customers in defining the business solution.

Medical Coder Grade A (Jan 2009 to Nov 2009))
GENASCIS (GPM Technologies in India – A PMG Partners in US), Noida
Responsibilities:
Provided coding expertise to various clients of highest accuracy in terms of surgical, radiology and anesthesia reports.
Mentored and developed successful teams of Junior Coders and Trainees.
Worked as both an overlay function supporting the team and as an individual contributor towards all Outpatient/inpatient coding, Orthopedic Surgeries, Cardiology Surgeries, Ear, Nose, Throat (ENT) Surgeries. Colonoscopy, EGD, Laparoscopic surgeries, Knee, Shoulder, & Ankle arthroscopy and common open procedures, Spine injections, Discographies, Ganglion blocks, Joint injections, Lyses of epidural adhesions, Blood patch, Neurolysis, Nasal Endoscopy and Sinus procedures, Labor & Delivery, Obs & Gynae laparoscopic procedures, Hysteroscopy procedures, Laryngoscopy, Male reproductive system procedures, Fractures (open/closed) vs.

malunion/nonunion and dislocations, Breast Procedures, Cystoscopy and Prostate procedures, Laceration Repairs (tendon, nerve, blood vessels, etc,). Radiology (ultrasound, x-ray chest, CT scan, MRI etc.

Medical Coder Grade C (Aug 2005 to Dec 2008)
PACIFIC VENTURES PVT LTD, NOIDA
Responsibilities:
provided coding expertise to various clients of highest accuracy in terms of surgical, radiology and anaesthesia reports.
Mentored and developed successful teams of Trainees.
Worked as both an overlay function supporting the team and as an individual contributor towards all Outpatient coding/inpatient, Orthopaedic Surgeries, Cardiology Surgeries, Ear, Nose, Throat (ENT) Surgeries. Colonoscopy, EGD, Laparoscopic surgeries, Knee, Shoulder, & Ankle arthroscopy and common open procedures, Spine injections, Discographies, Ganglion blocks, Joint injections, Lyses of epidural adhesions, Blood patch, Neurolysis, Nasal Endoscopy and Sinus procedures, Labor & Delivery, Obs & Gynae laparoscopic procedures, Hysteroscopic procedures, Laryngoscopy, Male reproductive system procedures, Fractures (open/closed) vs. malunion/nonunion and dislocations, Breast Procedures, Cystoscopy and Prostate procedures, Laceration Repairs (tendon, nerve, blood vessels, etc,). Radiology (ultrasound, x-ray chest, CT scan, MRI etc. Expertise in Assigning accurate cpt codes, E&M The three key components with emphasis on MDM and other subjective aspects of the Documentation Guidelines Coding per NCCI, ICD-10-CM, CPT® Modifiers and both the 1995 and 1997 Documentation Guidelines The three key components with emphasis on MDM and other subjective aspects of the Documentation Guidelines Risk assessment, including (but not limited to) the ability to benchmark, identity problematic situations and missed billing opportunities. Defined and refined existing processes and policies through research work in response to coding review cases with expertise in ICD-10CM diagnosis coding

EDUCATION
BAMS (Ayurveda), A&U Tibia Medical College (DU) in 2005, specializing in ayurvedic medicine & research on drugs
D. Pharma (Diploma in pharmacy), D. V. College of Pharmacy (Haryana Board of Technical University) in 1998
Diploma course in computer from zentek computer education.

TRAINING & CERTIFICATIONS
Certified Professional Coder (CPC®), Certified Professional Coder® from American Academy of Professional Coders (AAPC) from US in 2008
Certified Coding Associate (CCA®), Certified Coding Associate® from American Health Information Management Association (AHIMA) in 20013 from Dubai (U.A.E)
Certified ICD-10-CM proficiency Assessment in 2015 from AAPC
Certified in ICD10 documentation for physicians- multispecialty in 2015 from AAPC
Gained knowledge in Lean Ace and Six Sigma; used to implement different process improvements and best practice sharing.
HIPPA Training
Completed New Manager Induction Training
Completed training program in Revenue Cycle Management (RCM)
Completed Accelerated Healthcare Reimbursement Program (AHRP), certified by INGENIX
Completed training program in ICD-10, certified by INGENIX
Completed training program in MS Office (Access, Excel, PowerPoint, and Word)
Trained in six sigma, online training of white and yellow belt
Completed CDI (clinical documentation improvement) training program.

PERSONAL PARTICULARS
STRENGTH: Creativity, Alertness, Good power of observation, Confidence, Good decision making, Positive attitude, Cheerful, Friendly nature, work well in teams, sense of responsibility, Stress taking abilities, Energetic, open minded and resourceful. I'm optimistic, have a good sense of humor and get on easily with people of all ages and extremely professional. I can communicate well with all sorts of people, enjoy socializing and can set my mind to anything.
Date of birth: 11 November 1974
Languages known: English and Hindi
Other Activities : o Awarded Gold medal for running competition in 10th.
o Playing Hockey, Cricket & Table Tennis at school level.
o Won prize in song & dance competition at college level.