I have extensive experience handling insurance claims and managing denial processes. In my previous role, I reviewed and processed claims, identified common reasons for denials, and worked with the team to resolve them efficiently. I am well-versed in compliance regulations and have a proven track record of reducing denial rates by implementing streamlined procedures.

I prioritize tasks by assessing the urgency and complexity of each claim. I focus on resolving high-priority issues first, such as claims that require immediate attention due to deadlines or errors. I also use tools like task management software to organize and track progress, ensuring that no claim is overlooked.

I remain calm and empathetic when dealing with frustrated customers. I listen to their concerns, explain the reasons for the denial clearly, and provide options for appeal or resolution. By maintaining a professional and understanding demeanor, I aim to de-escalate situations and build trust with the customer.

I proactively review claim submissions for completeness and accuracy before submission. I also collaborate with other departments to address common issues that lead to denials, such as missing documentation or coding errors. Additionally, I provide training to staff on best practices to ensure claims are processed correctly the first time.

I regularly attend industry webinars, read relevant publications, and participate in training sessions to stay informed about changes in regulations and policies. I also network with peers and join professional associations to gain insights into emerging trends and best practices in the insurance industry.