Kamaldeep Suyal

About Kamaldeep Suyal

Detail oriented, Quick learner, team player, with great interpersonal skills!Specialties: •EDI, 5010, SQl Server, Medical coding. •Proficient in computer like MS office tool, Database, few languages and pre-built medical software/applications.•Expertise on ICD9 to ICD10 Transformation.•End to End Revenue Cycle Managment.•State Fee Schedule Development expertise. • Expertise on Medicare Coverage Database Development (LCDs & NCDs)•CPC Certified•ICD10 CertifiedEdifecs SpecBuilder Certified AssociateEdifecs XEngine Certified AssociateHL7 Certified V2.7 COntrol SpecialistProfessionally with a sound base built with rich & extensive experience from different organizations in different capacities. Extensive experience in all aspects of US Health Care domain ranging from but not limited to Revenue Cycle Management i.e. Medical coding, Medical billing, Accounts Receivables, Claims adjudication, Medical policy remediation, Electronic data interchange (EDI) processing for HIPAA transactions, claim life cycle, SQL server queries. Conceptually strong possessing an analytical & innovative approach towards work with an eye for detail along with the ability to quickly learn new concepts & technology. A team player with strong communication, analytical, organizational and relationship management skills.Extensive experience in healthcare EDI HIPAA transactions 270,271 834, 835,837(I, P&D), 5010 claim processing, ICD-9-CM, and HCPCS/CPT, ICD-10-CM/PCS coding systems and APR/MS-DRGs Reimbursement System. Strengths include very good command over SQL server, reporting, SQL complex queries executions, XML and JavaScript. Hands on experience gathering project requirement, creating fit gap analysis and design documentation.

Experience

1. Lead Business Analyst

   Edifecs

   Apr 2022 — Present · Bellevue, WA, US

   Responsible for consult, implement and provide system support to Edifecs healthcare Tools/Products (Spec/Map builder, XES server, TM).• Working with Clinicians, Business Analyst and Project Manager to establish credibility at all levels within the client and build problem-solving partnerships.• Creating Fit gap Analysis and design document based on the client’s project requirement.• Providing Edifecs product demo to client to ensure they understand all the product functionality and features very well.• Responsible for installation and deployment of Edifecs product in client’s environment.• Responsible for creating, customizing HIPAA guidelines (5010) for required transactions (27x, 83x) as per provided specification from customer.• Responsible for building maps (data transformation) based on project/ customer’s requirement.• Responsible for providing after project go-live support for any production related issues/defects.• Responsible for interacting with client on daily basis to provide progress update, discuss issues/gaps and plans. • Responsible for providing database reports and other data statistics repots as asked by customer.• Responsible of overall successful implementation of assigned project as a team player.

Education

• American Academy of Professional Coders, UT, USA

  CPC, Medical Insurance Coding Specialist/Coder

  2009 — 2010

• Aptech

  ADISM, Advance Diploma In System Information Managment.

  1997 — 1998

• NATIONAL SMALL INDUSTRIES CORPORATION LTD

  Computer Hadrware Engineer, Computer Hardware & Networking

  2004 — 2005

• Edifecs university

  Edifecs SpecBuilder Certified Associate, Spec Builder, Map Builder

  2016 — 2016

• Nainital University

  B.Sc., Life science

  1997 — 2000

• Edifecs university

  Edifecs XEngine Certified Associate, XEngine, XE server, EAM

  2016 — 2016

• ICD-10 Coders' Academy, IL, USA

  Certified ICD-10 Consultant®, ICD-10 Implementation

  2011 — 2012

• Govt Inter College, Almora, UK

  Intermediate Education, Physics, Chemistry, Biology

  1995 — 1997

Skills

• Icd-9
• Medical Billing
• Claim
• Six Sigma
• Electronic Medical Record (Emr)
• Medical Coding
• Microsoft Excel
• Revenue Cycle Management
• State Fee Schedule
• Cpt
• Medical Records
• Invoicing
• Current Procedural Terminology (Cpt)
• Hcpcs
• Database Admin
• Icd-10
• Healthcare
• Hipaa
• Medicare Coverage Determination
• U.s. Health Insurance Portability and Accountability Act (Hipaa)
• Database Management
• Icd-9-Cm
• Lean Thinking
• Health Information Management
• Drg
• Databases
• Revenue Cycle
• Medicine
• Ehr
• Medicare