About Priya Unnikrishnan

    • FunctionBilling, Coding, Credentialing
  • Specialty Other
  • Academic Level Master’s Degree
  • Institution Bharatiyar University
  • Major
  • Degree
  • School location
  • From
  • To
  • Current Compensation: 698000
  • Compensation Type Annually

Experience

  • 2015 - 2015
  • 2019 - Present
    Senior Medical Coding Analyst

    Athenahealth Inc., Chennai

    CLIENT INTERACTIONS AND ASSISTANCE • Understand client queries, apply the coding expertise, and provide appropriate resolution to resolve the case within 24hrs, salesforce cases handling. • Provide education or guidance to providers or practice as per updated coding and payor specific guidelines. • Assist practice in understanding the denial reason and submit appropriate corrected claim on behalf of the practice. • Understand the root cause of the presented issue and bridge the product or service gaps to enhance customer experience and satisfaction. • Identify trends & themes pertaining to client, specialties or parameters and assist with helping long term fix for improving client satisfaction rate. • Connect with stakeholders, analyze, and present findings to larger forum to resolve pressing client concerns. MEDICAL CODING ACCURACY PROCESS • Manage the ATA process efficiently aligning with the client & specialty expansion plans and internal stake holders. • Utilization of product QA feature to baseline the quality and set competitive goals for BPO to improve the internal quality. • Support vendor strategy program through effective quality monitoring & focus on performance sustenance. • QA backup support to bridge resource deficit at BPO teams assisting laid out BCP plans. • Knowledge of End-to-End RCM resolution process and Denial coding. 2 Operations Analyst/Athenahealth Inc., Chennai (10 June 2019 – 30 April 2021) STAKEHOLDER & TEAM INTERACTIONS • Continually analyze and actively recommend improvements to existing product features and related processes to maximize performance and efficiency. • Research; analyze and present solutions to client escalations. • Identify & resolve workflow gaps and latest payer updates on the process. • Proven ability to build effective work-relationships and strong interpersonal skills. • Supports patient care by resolving prior authorization issues and maintaining quality assurance. • Identification of root causes obtained through thorough analysis and communicate findings of project status with product team and stakeholders. • Perform focused or random audits based on the quality requirement and communicate the findings and action plans to the senior team members. • Identify and enhance web-portal availability to minimize the number of calls and in turn reduce the cost to the company. • Took part in cross-process trainings and helped conduct coding updates training for colleagues. • Assisted in developing medical coding training manuals for internal and external use. • Assisted in training and quality check of new hires. VENDOR QUALITY MANAGEMENT & RCM PROCESS • Perform monthly error analysis and auditor efficiency to identify top parameters and identification of training opportunities to improve process knowledge of vendors. • Review accounts to ensure quality in prior-authorization and referral process. • Contribute to CPT mapping ATA process and production & training of new-hires for the process. • Provide constant feedback to vendor QA’s and identify process delays avoiding client reworks. • Participate in regular QA calibration sessions to ensure process regularity. • Adhere to workflows and standards while constantly working on to improve the process guidelines as and when necessary. • Denial management: Contact insurance payers to check on the status of a claim and take appropriate action needed. • Check prior- authorization requirements through provider portal or call with the payer. Add-ons • Understanding of Agile methodology, Quality management & Healthcare Data Standards

  • 2013 - 2015
    Medical coder

    Ajuba solutions, Chennai

Honors & awards