Rajesh Kannan Raja

A Physiotherapy graduate, working as a Medical Coder for 10Years

Certified Coding Specialist (CCS) certified by AHIMA (USA) and Certified Professional Coder (CPC) and (Certified Outpatient Coder) COC Certified by AAPC (USA)

Having strong knowledge in PCS, CPT-4, ICD-10-CM, HCPCS Level II, and

Reimbursement methodologies, Human Anatomy, Physiology and Medical

Terminologies.

Have experience in Specialties – Inpatient Coding - Evaluation and Management

for Multiple Specialties , Outpatient – E and M for Multiple specialties, ED Coding,

Radiology and Medicine service coding, Office procedures coding, Claim Processing,

Reimbursement, Denial Management, Coding Process trainer, Supervising Coding

process and conducting training sessions to Coders.

• Proficiency in Manuals – ICD-10-PCS,CPT, ICD –10-CM, HCPCS Level II, CCI Edit, LCD,

Reimbursement Techniques, Software Handling (e-Clinical Works, All script, Citrix,

Medaptus, coding tools (CCI Edit, Super coder) and Health Information Management

system.

• Managing process flow to maintain clean claims and reduce rejections.

In-depth knowledge of coding techniques and guidelines of medical coding.

Very sound knowledge of medical terminology, Anatomy, Physiology and

pharmacology

Assigning codes for procedures, diagnosis using manuals like ICD 10 CM, CPT and

DSL codes

 Proficient in 3M coding software for assigning codes

 Proficient in handling EHR – Epic

 Inpatient, Outpatient and Emergency Medicine coding

 Assigning codes based on physician notes and other relevant documents and if

any discrepancy found, raise relevant queries to concerned team to justify the

assigning codes

 Raising Physician queries for documentation deficiency, justification of medical

necessity of ordered and performed services

 Following up denials and formulate check points based on denials to avoid further

denials

 Effective physician communication regarding documentation significance of all

services, medical necessity of ordered services

 Effective communication with other departments like Nursing, Paramedics and

other healthcare professional for importance of documentation

Certified Coding Specialist (CCS) certified by AHIMA (USA) and Certified

Professional Coder (CPC) and (Certified Outpatient Coder) COC Certified by AAPC (USA)

•Having strong knowledge in PCS, CPT-4, ICD-10-CM, HCPCS Level II, and

Reimbursement methodologies, Human Anatomy, Physiology and Medical

Terminologies.