nihalmumtajnm
About Candidate
I am an AAPC CPC–certified Medical Coder with over 3 years of experience in medical coding, claims processing, and revenue cycle management across UAE and Indian healthcare systems.
I have hands-on experience in ICD-10-CM, CPT, and HCPCS coding, along with insurance claim submission, rejection handling, and resubmission using MediMate 24/7, eClaimLink, Riayati, and insurance portals. I am well-versed in DHA guidelines, UAE insurance workflows, and medical & dental claims, ensuring high accuracy.
Location
Education
Work & Experience
• Performed accurate medical coding using ICD-10-CM, CPT, and HCPCS in compliance with DHA guidelines. • Prepared, submitted, and tracked insurance claims via MediMate 24/7 and eClaimLink. • Handled claim rejections, analysed root causes, and supported timely resubmissions. • Verified patient eligibility, demographics, and clinical documentation prior to submission. • Coordinated with coding, billing, and QA teams to improve first-pass acceptance rates. • Ensured adherence to HIPAA and UAE insurance regulatory standards.
• Executed medical and dental coding under DHA and UAE insurance regulations. • Verified insurance eligibility and obtained approvals via Riayati, DPHO, and payer portals. • Reviewed clinical documentation to ensure coding accuracy and completeness. • Identified documentation gaps and supported providers for clarification. • Assisted in resolving coding and billing discrepancies to minimize claim denials.
• Analysed international medical claims for service details, provider information, and charges. • Interpreted medical invoices and documentation in line with HTH / GeoBlue standards. • Processed claims in accordance with policy coverage and payer guidelines. • Conducted claim audits to ensure accuracy, completeness, and compliance. • Supported QA initiatives to improve turnaround time and overall claim quality.
• Assigned accurate ICD-10-CM, CPT, and HCPCS codes across multiple specialties. • Reviewed patient records for documentation completeness and coding compliance. • Maintained strict adherence to HIPAA and CMS regulations. • Identified and resolved coding discrepancies, reducing rework and denials. • Contributed to quality improvement initiatives to enhance coding accuracy and productivity.