In my previous role as a Charge Review Specialist at XYZ Healthcare, I was responsible for reviewing and auditing medical billing codes to ensure accuracy and compliance with insurance regulations. I utilized advanced software to identify discrepancies and worked closely with the billing team to correct errors, which significantly reduced claim denials and improved revenue cycle management. My experience includes a deep understanding of CPT, HCPCS, and ICD-10 coding systems, ensuring that all charges are appropriately documented and submitted.

When encountering discrepancies in medical billing codes, I first conduct a thorough review to understand the root cause. I then collaborate with the healthcare providers and coders to verify the accuracy of the codes. If corrections are needed, I ensure they are made promptly and that all parties are informed. My approach involves maintaining clear communication and documentation to prevent future errors and to uphold compliance with billing standards.

To stay current with healthcare billing regulations, I regularly attend webinars, workshops, and training sessions offered by professional organizations such as the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). I also subscribe to industry newsletters and participate in online forums to discuss and learn about new policies and best practices. This proactive approach ensures that my knowledge remains up-to-date and relevant.

In a previous role, I encountered a recurring issue where certain high-cost procedures were being miscoded, leading to frequent insurance denials. I conducted a detailed analysis, identified the coding errors, and developed a comprehensive training program for the coding team. This intervention not only resolved the immediate issue but also improved overall coding accuracy, resulting in a significant reduction in claim denials and an increase in revenue.

I prioritize tasks by assessing the urgency and impact of each project. I use project management tools to track deadlines and milestones, ensuring that high-priority items are addressed first. I also maintain open communication with my team and stakeholders to align on expectations and adjust priorities as needed. This methodical approach ensures that all projects are completed efficiently and effectively, meeting both regulatory requirements and organizational goals.