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Rathlavath Raghu Naik

@rathlavathraghunaik

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Highly skilled Senior Medical Coding Analyst with extensive coding experience.

India

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What I'm looking for

I am looking for a role that values accuracy and collaboration, offering opportunities for growth in medical coding and compliance.

I am a highly skilled and credentialed medical coding professional with extensive experience in Emergency Department (ED) professional coding, Evaluation and Management (E/M) coding, and Ancillary Services coding. My proficiency in applying CPT, ICD-10-CM, and HCPCS guidelines ensures accurate, compliant, and timely coding. I am recognized for my strong attention to detail and excellent analytical skills, which enable me to interpret complex clinical documentation effectively.

Throughout my career, I have maintained a proven track record of supporting revenue cycle integrity and reducing claim denials. I have collaborated effectively with healthcare providers and billing teams, dedicated to maintaining high coding accuracy and productivity in dynamic, high-volume environments. My experience spans various roles, including Senior Medical Coding Analyst at Optum Global Solutions, where I achieved a 98% accuracy rate in coding ED professional records.

Experience

Work history, roles, and key accomplishments

Current

Senior Medical Coding Analyst

Current

Optum Global Solutions Pvt Ltd

Feb 2023 - Present (3 years 4 months)

Coded ED professional records using CPT and ICD-9/10 with a 98% accuracy rate. Reviewed charts, validated signatures, and ensured compliance with coding guidelines and payer-specific policies.

CPT ICD 10 Coding Compliance Radiology Lab

Coding Expert

IKS Health

Mar 2022 - Present (4 years 3 months)

Specialized in E/M and OBGYN outpatient coding using 2021, 1995, and 1997 guidelines. Coded obstetric services and various surgical procedures including hysterectomies and biopsies.

OBGYN Coding Hysterectomies Team Leadership Coding Standards

Senior Coding Analyst – EMS Coding Specialist

R1 RCM

Aug 2019 - Present (6 years 10 months)

Reviewed transport and clinical data for ambulance claims and applied appropriate HCPCS and ICD-10 codes. Communicated with hospitals and insurers to obtain missing or unclear patient documentation.

EMS Coding Ambulance Claims HCPCS ICD 10 Coding Claims

Process Specialist – Subject Matter Expert

Cognizant Technology Solutions (CTS)

Sep 2015 - Present (10 years 9 months)

Performed outpatient coding for multiple specialties including ENT, ER, E/M, and Physical Therapy. Oversaw team production, conducted quality checks for new joiners, and ensured SLA adherence.

SLA Client Updates Process Improvement

Executive Medical Coder – ED Professional Coder

Omega Healthcare Solutions

Jun 2014 - Present (12 years)

Coded ED professional records with a consistent 98% accuracy and productivity rate. Conducted chart reviews and verified documentation compliance for clean claims processing.

ED Professional Coding Productivity Chart Reviews Clean Claims Processing