I have extensive experience in handling insurance claims and managing denials. In my previous role, I successfully reduced denial rates by 15% through meticulous review and correction of claims before submission. I am well-versed in navigating payer guidelines and resolving complex claim issues, ensuring timely and accurate reimbursement.

I prioritize tasks by assessing the severity and impact of each denial. High-priority claims, such as those affecting patient care or involving significant financial loss, are addressed first. I also use a tracking system to monitor progress and ensure no claim is overlooked.

To prevent claim denials, I conduct regular audits of submitted claims to identify common errors. I also provide training to staff on coding and billing best practices and maintain up-to-date knowledge of payer policies. By implementing these strategies, I aim to minimize denials and improve overall claim accuracy.

I maintain clear and professional communication with both insurance companies and internal teams. For insurance companies, I ensure all correspondence is detailed and compliant with regulations. With internal teams, I provide regular updates and collaborate to resolve issues efficiently, fostering a cooperative environment.

In a previous role, I encountered a denial due to incorrect coding. I reviewed the documentation, consulted with the coding team, and resubmitted the claim with the correct information. I also followed up with the insurance company to ensure the claim was processed promptly. This proactive approach resulted in a successful resolution within two weeks.