I have over five years of experience in medical coding and claims processing. I have worked extensively with ICD-10, CPT, and HCPCS codes, ensuring accurate and timely submission of claims. My role involved auditing claims for compliance with payer guidelines and resolving any discrepancies to prevent claim denials. I am proficient in using various claims management systems and have a strong understanding of the claims lifecycle.

I prioritize data accuracy by following a rigorous validation process. This includes double-checking all codes and data entries against the original documentation. I also utilize automated tools and software to cross-verify data and identify any anomalies. Additionally, I maintain a detailed audit trail to track changes and ensure accountability. Regular training and staying updated with industry standards further enhance my ability to maintain high data integrity.

To manage a high volume of claims without compromising quality, I employ a systematic approach. I prioritize tasks based on urgency and complexity, using time management techniques to allocate my time effectively. I also leverage technology, such as claims processing software, to streamline repetitive tasks and reduce manual errors. Regular breaks and maintaining a healthy work-life balance help me stay focused and productive throughout the day.

One challenging issue I faced was a claim that was repeatedly denied due to incorrect coding. After reviewing the documentation, I identified that the diagnosis code was incorrectly mapped to a procedure code. I corrected the coding and provided a detailed explanation to the payer, highlighting the correct coding guidelines. I also followed up with the provider to ensure they were aware of the correct coding practices. This proactive approach resulted in the claim being approved on the next submission.

I stay updated by regularly attending industry conferences, webinars, and training sessions. I also subscribe to relevant journals and newsletters that provide updates on coding guidelines and regulatory changes. Additionally, I participate in professional organizations and online forums to network with peers and share knowledge. By continuously educating myself, I ensure that my coding practices remain compliant and up-to-date with the latest industry standards.