Sanjay Kumar Singh

Background

About Sanjay Kumar Singh

CURRENT Interest: Autonomous Medical Coding through reasoning models GPT-o1 & GPT-4o: Applied NLP deep technology (Text Analytics-Healthcare); Designed to extract and label critical medical information from unstructured text. 1. Entity Recognition: •Identifies medications dosages medical conditions diagnoses procedures anatomical structures patient demographics and healthcare providers. 2. Relation Extraction: •Links medications with dosages. •Connects conditions to treatments. •Analyzes time associations and contextual qualifiers (e.g. negation certainty). 3. Entity Linking: Maps text to standard codes such as ICD-10 SNOMED CT RxNorm and LOINC. RCMaI Customizations: Real-time claims scrubbing & denial management through decision rules. RELEVANT Past: Core skills applied as below during tenure (2016-2022) of RCM officer with Mediclinic Middle East; A) Business Skills 1: Utilization of Data Analysis & BI (MS Excel-Expert level SQL & Power BI) for different Hospital Departments performance Doctor’s contribution into hospital’s monthly target control on finance & costing improvement in the team production and continued improvement in the claims quality through first submissions. B) Leadership: Digital interventions in RCM processes. Hospital system (EHR claim scrubbers & APIs) upgrades through algorithmic consultations to minimize “human errors /OR repeated errors” based on user’s feedback to adhere to federal audit remarks to raise confidence in stakeholders. This approach helped greatly in the improvement of denial % also. C) Critical Thinking 1: Working as SME on ‘Artificial Intelligence/Machine learning algorithms’ to make RCM processes more lean and dependable. [For e.g.: RPA to pick authorizations from HTML/PDF format EHR alert for type of visits (New Established OR Emergency) EHR alert for "follow up visits" following HAAD rule]. D) Critical Thinking 2: Continued efforts to add new sources of hospital revenues from the trending market practice.  E) Critical Thinking 3: System integrations in line with contractual fine lines with health authorities (currently HAAD & MOH) federal audit companies (currently Tasneef-TRBA for JAWDA data certification) and insurance companies for billing and coding policies and guidelines to avoid penalties or claims rejections. F) Business Skills 2: People management for SMART (Specific Measurable Achievable Realistic and Timely) Goals. G) Ethical Judgment 2: Continued Training & Education to Doctors Coders and Allied services.