Prathibha Gopalakrishnan
Doha,Qatar
Summary
Experienced clinical coding professional with 10 years of expertise in translating medical diagnoses and procedures into codes for patient records. Proficient in extracting relevant information, collaborating with healthcare providers, and ensuring precision. Holds a master's in biotechnology, CCS certification from AHIMA, and CPC certification from AAPC. Possesses a thorough understanding of anatomy, physiology, and medical terminology. Recognized for strong problem-solving skills and the ability to thrive in dynamic healthcare environments while upholding confidentiality and ethical standards.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Clinical Coding officer
Santa Fe Associates International, Assigned to Primary Health Care Corporation (PHCC)
10.2024 - Current
- Coding Outpatient claims using, ICD-10-AM /ACHI/ACS.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Implemented process improvements that streamlined coding workflows, increasing efficiency.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Ensured compliance with industry regulations and guidelines by staying up-to-date on the latest coding changes.
- Verified signatures and checked medical charts for accuracy and completion.
- Reviewed patient charts and identified discrepancies in the medical documentation
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Ensured all patient documentation is completed with extraordinary accuracy
- Ensured compliance with current health care regulations.
- Promoted teamwork within the department through effective communication and collaboration on complex cases.
- Facilitated improvement in the overall quality and completeness of medical record documentation through the query process along with formal and informal education.
- Maintained extensive interaction with physicians, nursing staff, other patient caregivers & medical records coding staff & ensuring complete documentation.
- Patiently dealt with a high volume of competing tasks in a fast-paced environment
- Trained junior coders on coding guidelines and best practices to enhance team performance.
Clinical Coding officer
Gulf Ware Housing Company (GWC), Assigned to Primary Health Care Corporation (PHCC)
09.2017 - 09.2024
- Coding Outpatient claims using, ICD-10-AM /ACHI/ACS.
- Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
- Increased coding accuracy by diligently reviewing medical documentation and applying appropriate codes.
- Implemented process improvements that streamlined coding workflows, increasing efficiency.
- Applied official coding conventions and rules from American Medical Association and Centers for Medicare and Medicaid Services to assign diagnostic codes.
- Ensured compliance with industry regulations and guidelines by staying up-to-date on the latest coding changes.
- Verified signatures and checked medical charts for accuracy and completion.
- Reviewed patient charts and identified discrepancies in the medical documentation
- Resourcefully used various coding books, procedure manuals, and on-line encoders.
- Ensured all patient documentation is completed with extraordinary accuracy
- Ensured compliance with current health care regulations.
- Promoted teamwork within the department through effective communication and collaboration on complex cases.
- Facilitated improvement in the overall quality and completeness of medical record documentation through the query process along with formal and informal education.
- Maintained extensive interaction with physicians, nursing staff, other patient caregivers & medical records coding staff & ensuring complete documentation.
- Patiently dealt with a high volume of competing tasks in a fast-paced environment
- Trained junior coders on coding guidelines and best practices to enhance team performance.
Medical Coder
Revenue Med India Pvt. Ltd (U.S Based)
02.2011 - 01.2014
- Performed Emergency, outpatient coding & E/M coding with ICD 9 CM, CPT and HCPCS codes.
- I am accountable for assessing electronic documentation, extracting data and analyzing medical information from electronic patient records to assign and sequence appropriate diagnostic and procedural codes using ICD9 CM/CPT/HCPCS Coding classification system and notify physicians about noncompliance.
- Coded preauthorization request for Outpatient and Inpatient claims.
- Reviewed & analyzed health records to identify relevant diagnoses & procedures for distinct patient encounters.
- Abstracted, analyzed, translated and data entered complex medical patient care records into diagnostic and procedural Coding.
- Conducted regular quality assessments to ensure valid Coding procedures and accurate collection of health information and data
- Maintained accuracy for reflection of scope & practice for unique specialty
- Underwent online ICD 9 CM Training (MC Strategies/www.webinservice.com) (AHIMA&AAPC Certified course)
Education
MSc - Biotechnology
St. Thomas College
BSc - Botany
Alphonsa College
Kerala, IndiaHigher Secondary Education -
St. Mary’s Higher Secondary School,Palai
Kerala, IndiaSSLC -
St Mary’s Higher Secondary School, Bharananganam
Kerala, IndiaSkills
- ICD 10 AM/ACHI CODING
- ICD 10 CM/ CPTCODING
- HCPCS LEVEL2
- 3M encoder/ Cerner millenium
- Medical Terminology
- Clinical documentation
- Medical release of information ROI processes
- Time Management
- Detail Oriented
- Analytical skills
- MS Office
- Interpersonal communication
- Workflow management
Certification
- CCS Certified coding specialist by AHIMA Member ID :2821230
- CPC Certification by the American Academy of Professional Coders (AAPC) Member ID: 01185086
- ICD 10 Proficiency Assessment
LANGUAGE KNOWN
English
Hindi
Malayalam
Tamil
Disclaimer
Place: Qatar Date: 2025-07-16 Prathibha Gopalakrishnan
Timeline
Clinical Coding officer
Santa Fe Associates International, Assigned to Primary Health Care Corporation (PHCC)
10.2024 - Current
Clinical Coding officer
Gulf Ware Housing Company (GWC), Assigned to Primary Health Care Corporation (PHCC)
09.2017 - 09.2024
Medical Coder
Revenue Med India Pvt. Ltd (U.S Based)
02.2011 - 01.2014
MSc - Biotechnology
St. Thomas College
BSc - Botany
Alphonsa College
Higher Secondary Education -
St. Mary’s Higher Secondary School,Palai
SSLC -
St Mary’s Higher Secondary School, Bharananganam
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