Mueed Abdullah
Medical Coder And Auditor
Islamabad,Federal
Summary
I am registered as Certified Professional Coder (CPC), CPMA-Medical Auditor, Certified anesthesia coder ( CANPC ) from AAPC, with professional degree of Pharm D which benefited me with sound medical knowledge. I worked on wide range of coding specialties including; E&M, Radiology, Medicine, surgery (Integumentary, Gastroenterology and Urology), ICD-10 and HCPCS level II, DRG, ICD-10-PCS, Risk adjustment, health information system.
Versatile Case Manager with expertise in different working environments. Hardworking and dedicated to top outcomes. Excellent time manager, communicator and problem solver. Enthusiastic, eager to contribute to team success through hard work, attention to detail and excellent organizational skills. Clear understanding and well trained. Motivated to learn and grow!
Overview
7
7
years of post-secondary education
6
6
years of professional experience
Work History
Fraud and Abuse Case Manager, Freelancer
Rialitic Insurance Services
California
01.2021 - Current
- Building AI tools to reduce fraud and abuse cases in coding and billing.
- Developing SOP and reimbursement policies with state to state variance, index.
- Building algorithms, doing clinical analytical services to improve the documentation, detect the mistakes, abuse cases, increasing the efficiency of medical practices.
- Evaluated IEP for compliance with state and federal requirements regulations and rectified non-compliance issues immediately.
- Worked with different disciplines to provide cohesive care to patients.
- Trained new nurses in proper techniques, care standards, operational procedures and safety protocols to optimize performance and safety.
- Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented all patient interactions and interventions in electronic charting systems.
Manager Coding and Auditing
MDVision
Lahore, Punjab
10.2019 - 12.2020
- Worked as assistant manager coding and leading 20 odd members of team efficiently.
- Had conducted training session of billing team about most commonly used modifiers and how to resolve claims instantly.
- Worked on DME practice that was completely going off target and earned employee of the week in first month of joining.
- Worked on new signing of projects efficiently of AMB coding.
- Helped in development of new billing software of MDvision with IT professionals.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
- Conducted literature and coding reviews to adhere to state and federal standards.
- Identified new areas of scientific research and provided internal training.
- Defined testing protocols, quality assurance initiatives and clinic policies and procedures.
- Scheduled surgeries, managed pre-certifications and verified insurance coverage.
- Generated and reviewed incident reports, including employee write-ups, actualizing appropriate corrective action plans to mitigate ongoing and potential situations.
Coding Manager
Bellmedex
Rawalpindi, Punjab
01.2019 - 09.2019
- Worked on coding and billing of greenwood family practice.
- Worked on denial management related to DMEs and Surgery coding and billing issues.
- Conducted training sessions regarding medical coding and HIPAA compliance guidelines.
- Worked on new project of CDT coding and trained myself and my team.
- Worked on Emergency and AMB coding in surgery sections of over 10 million collection.
- Did ICD-10-CM to ICD-10-CA cross code mapping for one of our clients.
- Worked on Anesthesia coding and actively manage the denials from last 3 months and got team of the month award for that.
- Developed and updated policies and procedures, maintaining compliance with statutory, regulatory and local, state and federal guidelines relating to HIPAA, benefits administration and general liability.
- Conducted routine facility inspections, identifying areas needing improvement and eliminating hazards posed to staff and residents for continued compliance with associated regulations.
- Monitored and inspected staff processes to eliminate hazards posed for both residents and staff while ensuring continuous compliance with regulations.
Certified Medical Coder
MTBC
Rawalpindi, Punjab
01.2015 - 12.2018
- MTBC (Medical Transcription and Billing Company)
- Assigning CPT and ICD-10-CM codes to highest level of specificity with independent judgment ensuring that codes accurately reflects the documentation and visit.
- To make sure that the assigned codes meet all federal, legal and insurance regulations so service payments are obtained in a timely fashion.
- Resolved discrepancies and issues of healthcare professionals related to medical coding improving revenue cycle.
- Worked on account (Radiology) of more than 10,000 claims per month, helping in increasing revenue and secure future assignments by Implementing the knowledge CPT, ICD-10 and HCPCS.
- Currently working on one of Major accounts in MTBC as surgery coding specialist and evaluation and management coder with accuracy rate of 95%.
- Risk adjustment coding and mapping for chronic conditions.
- Reviewed, analyzed and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Entered orders into EMR system efficiently and without errors.
- Utilized active listening, interpersonal and telephone etiquette skills when communicating with others.
- Maintained updated knowledge of coding requirements, through continuing education and certification renewal.
Education
CPC - Medical Coding
AAPC
New York, NY 11.2018 - 11.2018
CPMA - Medical Auditing
AAPC
New York, NY 06.2019 - 06.2019
CANPC - Anesthesia Coding
AAPC
New York, NY 01.2021 - 01.2021
Bachelor of Science - Pharmacy
University Of Sargodha
Sargodha 01.2010 - 01.2015
Master of Science - Biopharmaceutics
Quaid E Azam University
Islamabad 01.2016 - 03.2018
Skills
MS-Officeundefined
Timeline
Fraud and Abuse Case Manager, Freelancer
Rialitic Insurance Services
01.2021 - Current
CANPC - Anesthesia Coding
AAPC
01.2021 - 01.2021
Manager Coding and Auditing
MDVision
10.2019 - 12.2020
CPMA - Medical Auditing
AAPC
06.2019 - 06.2019
Coding Manager
Bellmedex
01.2019 - 09.2019
CPC - Medical Coding
AAPC
11.2018 - 11.2018
Master of Science - Biopharmaceutics
Quaid E Azam University
01.2016 - 03.2018
Certified Medical Coder
MTBC
01.2015 - 12.2018
Bachelor of Science - Pharmacy
University Of Sargodha
01.2010 - 01.2015
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