Rekha Swaminathan

Worked as HCC coder in multiple Medicare and Medicaid projects. Proficient in HCC coding tool. Job duties include performing chart reviews and applying diagnostic codes based on services rendered in inpatient and outpatient setting.

Job duties included performing chart reviews to provide and/or verify accurate Medicare HCC diagnostic coding based on services rendered and performing coding quality reviews to assist in providing timely feedback and education. Coding and quality assurance reviews performed on standard and comprehensive HCC projects as well as inpatient projects. Maintained at least 96% on both coding accuacy and completeness. Remote position.

Job duties included performing chart reviews and applying HCC diagnostic coding based on services rendered in an outpatient setting. Familiarity with the content of health records and the content and structure of health care data. Use of encoder on simulated medical charts including paper, hybrid and electronic health record charts. Emphasis on day-to-day work of Medical Coders. Knowledge of HIPAA requirements and release of information.

Job Description

Abstracting clinical data from medical records and performing ongoing analysis of charts for the appropriate review compliance and researching and resolving assigned abstraction projects to drive other teams work on provider education on behalf of the insurance plan.

Duties and Responsibilities

• Performed the basic functions of the abstraction including ongoing analysis of medical record charts for the appropriate NCQA compliance. Followed and monitored regulatory changes as they pertain to HEDIS reviews and NCQA guidelines.
• Met and maintained production and quality expectations for all assigned measures.
• Performed daily responsibilities with acute attention to detail.
• Transitioned between priorities and abstraction projects based on program or client needs.
• Used Independent judgment to complete abstraction and review of medical records following program guidelines.
• Responsible for managing and utilizing confidential information from medical records in an appropriate manner following designated guidelines including HIPAA and company policies/guidelines.
• Applied HEDIS concepts and principles in the completion of abstraction and review process to ensure full recognition of delivered care for the benefit of the member.

Job duties included performing chart reviews and applying HCC diagnostic coding based on services rendered in an outpatient setting.

Familiarity with the content of health records and the content and structure of health care data. Use of encoder on simulated medical charts including paper, hybrid and electronic health record charts.

Emphasis on day to day work of Medical Coders. Knowledge of HIPAA requirements and release of information.

• Preparing Technical specifications and Program specifications.
• Unit Test Plan documents, Coding and Unit Testing.
• Helping out in preparing System Test Data, carrying out system testing and execution.
• Participating in Peer review activities in all phases.
• Worked in product change requests and IS fixing.