Nisha.

Worked with a UAE health insurance company, handling insurance claim denials and supporting clients throughout the claim process. Reviewed denied claims to identify the reasons for rejection, such as missing documents, incorrect information, coding errors, or policy-related issues. Guided clients on how to correct and resubmit their claims by explaining the rejection reasons and the required submission process. Cross-checked medical records and supporting documents to ensure all information was complete and accurate before resubmission. Gained a good understanding of the insurance workflow, from claim submission and review to approval or denial, while working with both the payer (insurance company) and the co-payer (the patient's share of the medical cost) to help ensure smooth and timely claim processing.

Worked as a Medical Coder with knowledge of HIPAA guidelines, ensuring the privacy and confidentiality of patient health information. Reviewed medical records and assigned accurate CPT and Evaluation & Management (E/M) codes based on the services provided by healthcare professionals. Identified and corrected coding errors that caused claim rejections and worked to resolve denied claims by reviewing the reasons, making necessary corrections, and resubmitting them for payment. Maintained coding accuracy while following industry standards and insurance guidelines to support timely claim processing and reimbursement.

Started my career by learning medical coding in detail and building a strong understanding of coding guidelines and healthcare documentation. Gained knowledge of HCC (Hierarchical Condition Categories), HHS (Health and Human Services) regulations, FEDIS (Healthcare Effectiveness Data and Information Set) measures, and followed HIPAA policies to ensure patient information remained private and secure. Learned how to review medical records, understand clinical documentation, apply coding standards accurately, and maintain quality and compliance in healthcare services. This training helped me develop strong attention to detail and a solid foundation in medical coding and healthcare processes.

I am a Certified Professional Coder (CPC), credentialed by the American Academy of Professional Coders (AAPC). This certification demonstrates my proficiency in medical coding, including accurate assignment of ICD-10-CM, CPT, and HCPCS Level II codes, as well as a strong understanding of medical terminology, anatomy, physiology, healthcare documentation, and coding guidelines. As a CPC-certified professional, I am committed to maintaining coding accuracy, regulatory compliance, and ethical standards while supporting efficient healthcare reimbursement and revenue cycle management.

I have successfully completed my Bachelor of Pharmacy (B. Pharm.) degree, where I gained comprehensive knowledge of pharmaceutical sciences, including pharmacology, pharmaceutics, medicinal chemistry, pharmacognosy, and pharmacy practice. Throughout the program, I developed a strong understanding of drug development, patient care, medication management, and healthcare ethics. This academic foundation has equipped me with the skills and confidence to contribute effectively to the pharmaceutical and healthcare sectors while continuing to expand my professional knowledge and expertise.

I have successfully completed my Higher Secondary Education (12th grade) in the Science stream with subjects including Physics, Chemistry, and Biology. This academic background has provided me with a strong foundation in scientific principles, analytical thinking, and problem-solving skills. Through my studies, I developed an understanding of biological and chemical sciences, laboratory practices, and scientific methodologies, preparing me for higher education and opportunities in healthcare, life sciences, and related fields.

I have successfully completed my Secondary School Education (10th grade) from the Central Board of Secondary Education (CBSE). During my schooling, I built a strong foundation in core subjects such as Science, Mathematics, Social Science, and English while developing analytical thinking, communication, and problem-solving skills. My education has helped me cultivate discipline, a commitment to learning, and the confidence to pursue higher studies and future career opportunities.