Sarathi Vicky

Background

About Sarathi Vicky

Conduct in-depth audits of medical records for HCC (Hierarchical Condition Categories) and HHS (Department of Health and Human Services) coding to ensure accuracy, completeness, and compliance with CMS guidelines. Review provider documentation to validate ICD-10-CM coding for chronic and complex conditions affecting risk adjustment scores. Utilize tools like Optum360, SF, and MRM to analyze coding patterns, flag discrepancies, and maintain high standards of data integrity. Collaborate with coding teams and physicians to provide feedback, identify documentation improvement opportunities, and support coding education initiatives. Monitor coding quality metrics and ensure all audits meet organizational benchmarks and regulatory standards. Maintain up-to-date knowledge of industry coding updates, HHS-RADV guidelines, and CMS risk adjustment methodologies. Contribute to process improvement strategies and support leadership in training junior auditors or coders.