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Nadira Sankar
Clermont,Florida
Summary
Results-driven Medical Billing Specialist with 15 years of experience in ICD-10, CPT, and Revenue Cycle Management. Expertise in coding accuracy, compliant documentation, and optimized reimbursement strategies. Collaborates effectively with physicians and RCM teams to ensure timely claims processing and minimize denials. Proficient in EHR systems including Epic, eClinicalWorks, and Athena, with a focus on operational efficiency and revenue enhancement.
Overview
24
24
years of professional experience
Work History
Medical Records Auditor
Humana
Clermont, Florida
02.2022 - 03.2026
- Reviewed medical records for compliance with healthcare regulations and standards.
- Conducted audits to ensure accuracy of patient information and documentation.
- Collaborated with healthcare staff to resolve discrepancies in medical records.
- Managed electronic health record systems for efficient data retrieval and organization.
- Trained new employees on auditing processes and documentation requirements.
- Analyzed trends in medical record errors to improve auditing procedures.
- Developed and maintained audit reports for regulatory compliance reviews.
- Implemented changes as needed to ensure efficient workflow processes related to medical record management activities.
- Maintained database of audit results including corrective actions taken by departments or individuals responsible for errors identified during audits.
- Recommended process improvements that would enhance the accuracy and efficiency of document retrieval from various sources within the organization.
- Ensured all personnel involved in handling protected health information adhere to HIPAA regulations.
- Conducted audits of patient medical records for compliance with regulatory requirements.
- Performed internal reviews to assess the effectiveness of current processes related to patient medical records management.
- Coordinated with external auditors providing oversight over organizational operations relative to patient safety regulations.
- Identified areas where improvements can be made in the organization's policies and practices related to medical record keeping.
Health Information Management Technician
AMICUS MEDICAL CENTER LLC
, United States
07.2021 - 02.2022
- Applied ICD-10-CM and CPT coding standards to ensure accurate charge capture, billing accuracy, and optimal reimbursement.
- Requested, reconciled, and maintained medical records from hospitals, specialists, imaging centers, and prior PCPs to ensure accurate billing and facilitate timely denial resolution.
- Collaborated with billing and revenue cycle management (RCM) partners to resolve coding errors and documentation gaps, streamlining claim issue resolution.
- Released protected health information to authorized parties in full HIPAA compliance, including attorneys, CMS, specialty providers (Cardiology, ENT, Pulmonology, Podiatry), imaging facilities, and prior primary care offices.
- Collected patient payments via phone, posted transactions to patient accounts, and followed up on outstanding balances to enhance collections.
- Downloaded, indexed, and organized 100+ radiology reports (X-ray, MRI, Echocardiogram) within the EMR by date of service and facility location; attached records to provider orders and flagged STAT reports for urgent processing.
Front Desk / Insurance Verification/ Scheduler
MyDoc Women's Health Specialists
06.2019 - 07.2020
- Coordinated high-volume patient scheduling and front-end billing for OB/GYN practice, ensuring accurate claims submissions and maximizing revenue capture.
- Coordinated patient scheduling for consultations and procedures at women's health facility.
- Managed appointment calendars to optimize provider availability and patient access.
- Communicated with patients to confirm appointments and provide necessary instructions.
Quality Assurance Specialist
Somnia Inc.
, United States
07.2008 - 07.2014
- Oversaw medical records quality and compliance for 10 hospitals nationwide supporting anesthesia services.
- Supported audits and quality assurance initiatives, ensuring adherence to payer and regulatory standards.
- Reviewed patient charts to identify documentation deficiencies, enhancing billing accuracy and coding compliance.
- Partnered with clinical and administrative teams to correct errors and improve documentation quality.
- Implemented Liberty Net scanning software, improving record accessibility, accuracy, and turnaround times.
- Managed critical billing documents including superbills, anesthesia records, consents, insurance data, and pre-operative reports.
- Trained and mentored staff on documentation standards and workflow, improving overall efficiency.
- Earned multiple Employee of the Month awards and annual performance incentives.
Medical Records Specialist
Somnia Inc.
, United States
06.2005 - 07.2008
- Collect Medical Records from Numerous Surgery Centers for Anesthesia Company.
- Sorted records by center, date of service, and audit criteria to prepare for billing team.
- Recorded patient data in excel by center, location, and date of service for ongoing tracking.
- Systematically organized and filed medical records for easy access and assisted staff with retrieval.
Teaching Assistant
James Weldon Johnson
06.2002 - 03.2005
- Teacher Assistant providing guidance to children in Pre-K and Kindergarten class with hands-on focused on care, guidance and early learning support.
- Assist the lead teacher during circle time, lessons and activities.
- Facilitated smooth transitions between classroom activities by guiding children during lining up, clean up, snack, and nap times, ensuring a structured and calm environment. between activities (lining up, clean up time, snack time, nap time, class field trips).
- Work one on one with small groups to support early learning literacy, numbers, shapes, colors and social skills.
- Reinforce lessons through play, songs, stories and hands on activities.
- Help set up learning centers, play areas and classroom materials.
- Monitored children's interactions and behaviors to assist lead teacher in addressing individual needs and developing tailored support strategies.
- Ensure children are safe, comfortable and supervised at all time.
- Provided comfort to upset children during morning drop-off, fostering a welcoming and supportive atmosphere.
Education
Medical Billing Specialist certificate - Medical Billing
Medcerts
Remote10-2025
Associate's degree - Computer Science
Touro University NYSCAS
New York, NY07-2024
Bachelor's degree - Computer Science
Touro University NYSCAS
New York, NY07-2022
Skills
- ICD-10
- Current Procedural Terminology (CPT)
- Medical billing
- Release of Information
- Documentation accuracy
- Data analysis
Timeline
Medical Records Auditor
Humana
02.2022 - 03.2026
Health Information Management Technician
AMICUS MEDICAL CENTER LLC
07.2021 - 02.2022
Front Desk / Insurance Verification/ Scheduler
MyDoc Women's Health Specialists
06.2019 - 07.2020
Quality Assurance Specialist
Somnia Inc.
07.2008 - 07.2014
Medical Records Specialist
Somnia Inc.
06.2005 - 07.2008
Teaching Assistant
James Weldon Johnson
06.2002 - 03.2005
Medical Billing Specialist certificate - Medical Billing
Medcerts
Associate's degree - Computer Science
Touro University NYSCAS
Bachelor's degree - Computer Science
Touro University NYSCAS