Moushmi K

About Moushmi K

I’m a Business Excellence leader with over two decades of experience driving transformation across the US Healthcare RCM and Coding space — spanning Payer and Provider Operations, Quality, Training, and Process Improvement. My passion lies in integrating AI and Lean Six Sigma to enhance performance, reduce inefficiencies, and drive data-led decision-making.I lead and mentor diverse teams across India and the Philippines, aligning enterprise strategies with business needs across end-to-end RCM, US Retail, Enterprose Acute Coding (ED, E/M, Surgery, Ancillary, Denial, IPDRG) and Risk Adjustment (HCC). A certified Business Excellence Master Black Belt and CPC (AAPC) professional with expertise in AI/ML and Project Management, I’ve implemented automation and AI-driven solutions that replaced manual processes, strengthened governance, and improved accountability across functions. Recognized with the President’s Circle Award (Cotiviti, May 2024), I take pride in fostering collaboration, innovation, and continuous improvement across global teams.My current focus is on exploring how AI can elevate operational excellence — from predictive quality models to human-in-the-loop systems that balance automation with judgment. I share insights on responsible AI adoption, digital transformation, and leadership in the age of intelligent systems.Follow my posts to explore how human potential and AI precision can coexist to shape smarter, more ethical, and future-ready organizations.#AITransformation #OperationalExcellence #QualityLeadership #AIInnovation #LeadershipInAI

Experience

1. Director Coding

   R1 RCM

   Jan 2026 — Present · Hyderabad, IN

   Key Responsibilities Lead large-scale medical coding operations, ensuring adherence to compliance and accuracy standardsBuild and manage high-performing coding teams across specialties (IPDRG, SDS, ED, EM, Edits/Denials, HCC, etc.)Drive strategic initiatives for automation, process improvement, and coder productivityPartner with clinical, quality, and training teams to build a robust coder upskilling frameworkInterface with senior stakeholders and clients to ensure SLAs and performance metrics are metStay current with industry trends, regulatory updates, and coding standards

Education

• Osmania University

  Master's Degree, Master of Arts in English

  2004 — 2006

• Sri Krishnadevaraya University

  Bachelor of Commerce (B.Com.), Commerce

  1998 — 2001

• Indian School of Business

  Certificate Program in Leadership with AI (2025), Artificial Intelligence