I have over five years of experience in medical coding and reimbursement, specializing in both inpatient and outpatient settings. I am proficient in using various coding software and have a strong understanding of the ICD-10 and CPT coding systems. My experience includes auditing claims, ensuring compliance with regulatory standards, and maximizing reimbursement for healthcare providers.

I regularly attend webinars, workshops, and training sessions offered by professional organizations such as AHIMA and AAPC. Additionally, I subscribe to industry newsletters and participate in online forums to stay informed about the latest changes and trends in healthcare regulations and coding guidelines.

I prioritize thorough documentation review and coding accuracy to minimize claim denials and rejections. I utilize automated tools for data validation and maintain a systematic approach to tracking and resolving coding discrepancies. Collaboration with healthcare providers and insurance companies is also key to ensuring smooth claim processing.

When a claim is denied or rejected, I first review the denial reason and the supporting documentation. I then work closely with the healthcare provider to gather any missing information or correct any errors. I prepare a detailed appeal letter, including all relevant documentation, and follow up diligently until the claim is resolved.

I once encountered a complex reimbursement issue involving a new procedure that was not initially covered by the insurance. Through extensive research and negotiation with the insurance company, I successfully argued for coverage based on medical necessity. This experience taught me the importance of persistence, detailed documentation, and effective communication in resolving challenging reimbursement issues.