Dhanesh Vijayan

Background

About Dhanesh Vijayan

Versatile, competent AHIMA & AAPC certified medical coding, auditing and compliance professional with 15 years of rich hand-on experience with reputable organizations. Skilled in managing all aspects of billing, coding, collections & compliance in hospital (inpatient, outpatient & emergency department) environment. Capable of leading a team of frontend employees including coders, auditors, billers, registrars & insurance verifiers assuring consistent high standards in service delivery Skilled in developing and delivering training modules on billing, coding & compliance procedures, EMR/HER and other hospital systems through online, PowerPoint & face-to-face presentations for physicians and coders. Competent in educating physicians, ancillary health staff & coders on coding documentation guidelines, CMS evaluation & management, reimbursement & specialty specific coding, billing & compliance guidelines. Experienced in liaising with hospital staff of various departments – medical records (required documents for charting), case managers (admission criteria), nurse managers (process flow for provider charting within the emergency department). Sound knowledge of hospital reporting systems like charge description master, ambulatory payment classifications & diagnosis related groups (DRG). Skilled in ensuring optimal reimbursement under prospective payment systems through review of IR-DRG assignments. Capable of preventing fraudulent practices like assignment of codes not conforming to approved coding principles & guidelines. Ensure correct reimbursement by unbundling services & codes not conforming to CPT basic coding principles. Proactive, achievement driven professional with strong work ethic, integrity and excellent communication, coordination, problem solving, decision making, planning & execution skills.