Usha Kommineni
Corinth,TX
Summary
Medical professional with over 23 years of diversified experience in Health Information Technology, medical coding, clinical documentation improvement, hospital operations, insurance claims processing, and quality auditing across U.S. and Indian healthcare systems. Experienced in ICD-9/ICD-10 transitions, Medicare/Medicaid policies, EMR implementation, and public health management.
Overview
23
23
years of professional experience
1
1
Certification
Work History
District Coordinator
Dr. NTR Vaidya Seva Health Care Trust
07.2024 - 09.2025
- Weekly hospital inspections focusing on infrastructure, staffing, sanitation, medication quality, and patient services.
- Monitored grievances, CCTV footage, hospital ratings, and operational compliance.
- Prepared district-level reports and coordinated MOUs and recruitment processes.
District Coordinator / Joint Executive Operations
Dr. YSR Aarogyasri Health Care Trust
09.2023 - 07.2024
- Oversaw project planning, insurance claim evaluation, and case escalations.
- Conducted hospital empanelment inspections and operational audits.
- Supported hospital–trust communication processes in real-time.
District Coordinator
Dr. YSR Aarogyasri Health Care Trust
12.2019 - 09.2023
- Conducted hospital audits, patient interactions, and assessments.
- Ensured medical quality compliance and monitored operational systems.
- Led grievance resolution and NWH documentation processes.
Hospital Coordinator (Insurance/Accounts)
Raja Rajeswari Medical College & Hospital
01.2019 - 12.2019
- Led insurance and billing operations including claims, receivables, and financial reporting.
- Trained staff and collaborated with hospital leadership for operational efficiency.
- Maintained patient profiles, supported audits, and improved workflow processes.
Resident Medical Officer
Apollo Spectra Hospital, Bangalore
04.2018 - 12.2018
- Supervised hospital operations including clinical, administrative, and financial areas.
- Coordinated with surgeons, patients, and insurers for procedure approvals.
- Improved workflows, maintained operational documentation, and coached staff.
Senior Insurance Analyst
Tarrant County Public Health, Texas
01.2017 - 05.2017
- Analyzed coding, billing accuracy, denials, appeals, and insurance enrollment.
- Managed Medicaid, Medicare, and commercial insurance queries.
- Led team functions for claims batching, submissions, and reporting.
Director – Provider Coding Network
Cook Children's Health System, Texas
04.2016 - 12.2016
- Developed coding policies and ensured compliance across provider networks.
- Collaborated with hospital executives on financial and clinical initiatives.
- Implemented quality improvement strategies using data-driven insights.
Principal Consultant / Project Manager
NTT DATA
03.2013 - 04.2016
- Managed ICD-9 to ICD-10 transition projects for Medicaid programs.
- Coordinated UAT, documentation, delivery schedules, and resource management.
- Developed contingency plans and supported federal/state compliance requirements.
Senior Business Analyst
Computer Science Corporation (CSC)
01.2012 - 03.2013
- Mapped ICD-9 to ICD-10 codes using Edifecs tools.
- Prepared validation reports, led remediation sessions, and documented coding workflows.
- Supported federal compliance mapping strategies.
Consultant
Ajilon / Kaiser Health Insurance
12.2010 - 01.2012
- Supported EPIC/ICD-9 implementation and billing workflows.
- Processed claims, updated AR, and maintained billing documentation.
- Ensured coding accuracy and processed complex claim inquiries.
Senior Claims Analyst
CBIZ, Kansas
11.2007 - 05.2009
- Coded anesthesia, emergency medicine, and diagnostic services.
- Resolved denials, CCI edits, and documentation inconsistencies.
- Performed charge capture audits and compliance reviews.
Claims Analyst
Saint Luke’s South Hospital, Kansas
02.2005 - 10.2007
- Conducted medical coding, Medicare billing, and documentation audits.
- Handled secondary billing, denials, and charge entry updates.
- Trained departments on charging and compliance procedures.
Primary Care Physician
Ashok Nursing Home, Bangalore
07.2003 - 12.2004
- Diagnosed and treated outpatient and inpatient cases.
- Conducted physical examinations, medical history reviews, and follow-up care.
- Prepared clinical documentation and patient counseling.
House Surgeon / Intern
KC General Hospital, Bangalore
08.2002 - 03.2003
- Provided clinical support across multiple specialties.
- Prepared medical summaries and assisted in patient evaluations.
Education
CEMP – Certified EMR Management Professional - undefined
HIT
USAHITECH – Health Information Management Redesign Specialist - undefined
JCCC
USA01.2011
Medical Coding Certificate - undefined
JCCC
USA01.2005
MBBS - undefined
Medical Council of Karnataka
India01.2003
Skills
- ICD-9/ICD-10, CPT, CMS Guidelines
- 3M, Cerner, Epic EMR; Edifecs Tools
- MS Office Suite (Word, Excel, PowerPoint, Visio, Project)
- TFS, SharePoint
- ICD-Data Tools
Certification
- Certified Professional Coder (CPC), AAPC
- Certified EMR Management Professional (CEMP)
- COVID-19 Telemedicine Certification – India
- Clinical Audit Certification – NABH (India)
- Continual Quality Improvement Certification – NABH (India)
Accomplishments
I got an Special award from State Chief Minister for excellence work as District Coordinator
Additional Information
I have moved back to my family in US. I started studying Clinical Documentation Specialist Integrity through AHIMA.
Core Competencies
- Medical Coding & Health Information Management
- Insurance Claims Processing & Revenue Cycle Management
- Hospital Operations & Quality Auditing
- Process Improvement and Risk Mitigation
- Project Management (Including ICD-9 to ICD-10 Transition)
- Public Health & Disaster Management
- Team Leadership and Staff Training
Timeline
District Coordinator
Dr. NTR Vaidya Seva Health Care Trust
07.2024 - 09.2025
District Coordinator / Joint Executive Operations
Dr. YSR Aarogyasri Health Care Trust
09.2023 - 07.2024
District Coordinator
Dr. YSR Aarogyasri Health Care Trust
12.2019 - 09.2023
Hospital Coordinator (Insurance/Accounts)
Raja Rajeswari Medical College & Hospital
01.2019 - 12.2019
Resident Medical Officer
Apollo Spectra Hospital, Bangalore
04.2018 - 12.2018
Senior Insurance Analyst
Tarrant County Public Health, Texas
01.2017 - 05.2017
Director – Provider Coding Network
Cook Children's Health System, Texas
04.2016 - 12.2016
Principal Consultant / Project Manager
NTT DATA
03.2013 - 04.2016
Senior Business Analyst
Computer Science Corporation (CSC)
01.2012 - 03.2013
Consultant
Ajilon / Kaiser Health Insurance
12.2010 - 01.2012
Senior Claims Analyst
CBIZ, Kansas
11.2007 - 05.2009
Claims Analyst
Saint Luke’s South Hospital, Kansas
02.2005 - 10.2007
Primary Care Physician
Ashok Nursing Home, Bangalore
07.2003 - 12.2004
House Surgeon / Intern
KC General Hospital, Bangalore
08.2002 - 03.2003
CEMP – Certified EMR Management Professional - undefined
HIT
HITECH – Health Information Management Redesign Specialist - undefined
JCCC
Medical Coding Certificate - undefined
JCCC
MBBS - undefined
Medical Council of Karnataka