Sowmya Varauri
Irving
Summary
Skilled Medical Coding Analyst with a proven track record at Optum, UnitedHealth Group, enhancing coding accuracy and compliance. Expert in ICD-10 and HIPAA regulations, I spearheaded initiatives improving documentation practices and reducing claim rejections. Demonstrated leadership by educating clinical staff and developing coder performance metrics, significantly optimizing reimbursement processes.
Overview
2
2
years of professional experience
1
1
Certification
Work History
Medical Coding Analyst
Optum, UnitedHealth Group
06.2022 - 06.2023
- Educated clinical staff on proper documentation practices to ensure accurate coding and compliance with regulations.
- Analyzed medical records and coded diagnostic and procedural information using ICD-10, CPT, and HCPCS coding systems.
- Collaborated with healthcare providers to ensure accurate documentation and timely reimbursement.
- Worked on several healthcare projects, including Medicare, ACA-Centene, and AIER, ensuring compliance with regulatory standards and optimizing reimbursement processes.
- Identified and resolved discrepancies in medical billing codes to reduce claim rejections.
- Ensured adherence to HIPAA and other regulatory standards, safeguarding patient privacy and confidentiality.
- Demonstrated commitment to ethical practice through adherence to established guidelines for privacy, confidentiality, and security of patient information.
- Developed a system for tracking individual coder performance metrics, enabling targeted feedback and support for continuous professional growth.
- Supported implementation of electronic health record system, assisting in the transition from paper to digital records for streamlined coding processes.
Program Coordinator
Magnus Group
11.2021 - 04.2022
- Facilitated regular meetings with team members to discuss progress updates, address challenges, and brainstorm solutions for ongoing success.
- Established strategic partnerships with external organizations, expanding program reach and impact.
- Maintained detailed records of program activities and participant data, ensuring compliance with internal policies and external regulations.
- Led training sessions for staff and volunteers, fostering a knowledgeable and cohesive team environment.
Education
Masters in Health Care Administration - Health Care
Indiana Wesleyan University
Marion, IN04-2025
Bachelors of Pharmacy - Pharmacy
Teegala Krishna Reddy College of Pharmacy
Hyderabad11-2021
Skills
- Procedural coding accuracy
- ICD-10 proficiency
- Quality assurance checks
- HIPAA compliance
- Medical terminology expertise
- Clinical documentation review
- CPT coding
- Medical billing
- HCPCS level II coding
- Data entry
- Proficient in ICD-10, CPT, HCPCS coding systems, and billing processes for healthcare providers
- Critical thinking
- Leadership qualities
Accomplishments
Certifications & Training
- Certified Medical Coder (AAPC CPC-A)Certified in medical coding, with a focus on ICD-10, CPT, and HCPCS codes for various healthcare settings.
- Basic Life Support (Aster Prime Hospital)Trained in providing basic emergency life-saving skills, including CPR and first aid.
- Clinical Data Management (CDM), Clinical Trials Management (CTM), Pharmacovigilance (PV)
Cliniindia InstituteAcquired advanced knowledge in the management of clinical trials, data handling, and the monitoring of adverse drug reactions, ensuring compliance with regulatory bodies.
- Advanced Program in Clinical Research and Management
Cliniindia InstituteSpecialized training in clinical research methodologies, management of clinical trials, ethical considerations, and patient safety in clinical research.
Intern
Qual Pharma Company
- Gained hands-on experience in pharmacy operations, including drug procurement, inventory management, and patient consultation.
- Assisted in the preparation of pharmaceutical products and monitored stock levels to ensure timely restocking of medications.
- Worked closely with pharmacists and other healthcare professionals to improve operational workflows and patient service delivery.
- Participated in the Pharmacy Conference at Vijaya College of Pharmacy, where I presented my research findings on pharmaceutical practices and innovations.
- Completed an Intensive Clinical Research Training at Startech Labs Private Limited, gaining hands-on experience in data management and research protocols.
Certification
- AAPC Fellow Recognition Program– American Academy of Professional Coders(AAPC).
- Texas Driver's License
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC).
Languages
English
Professional Working
Timeline
Medical Coding Analyst
Optum, UnitedHealth Group
06.2022 - 06.2023
Program Coordinator
Magnus Group
11.2021 - 04.2022
- AAPC Fellow Recognition Program– American Academy of Professional Coders(AAPC).
- Texas Driver's License
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC).
Masters in Health Care Administration - Health Care
Indiana Wesleyan University
Bachelors of Pharmacy - Pharmacy
Teegala Krishna Reddy College of Pharmacy
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