I have over three years of experience in DME billing and coding, where I handled claims submission, verified insurance eligibility, and ensured compliance with Medicare and Medicaid guidelines. I am proficient in using billing software like Brightree and have a strong understanding of HCPCS and ICD-10 codes. My attention to detail and knowledge of payer requirements have helped me maintain a high claim acceptance rate and minimize denials.

When a claim is denied or rejected, I first review the explanation of benefits (EOB) to identify the issue. Common reasons include coding errors or missing documentation. I then correct the error, gather necessary supporting documents, and resubmit the claim promptly. I also track denials to identify patterns and implement preventive measures, such as staff training or process improvements, to reduce future occurrences.

Compliance is critical in DME billing to avoid legal issues, penalties, and claim denials. It ensures adherence to regulations like HIPAA, Medicare guidelines, and payer-specific policies. I stay updated on regulatory changes and conduct regular audits to verify accuracy. By maintaining compliance, I protect the organization’s reputation, ensure timely reimbursements, and provide ethical billing practices that prioritize patient care.

I prioritize tasks by assessing urgency and importance, focusing on claims nearing deadlines or requiring immediate attention. I use organizational tools like spreadsheets or billing software to track progress and set reminders. By breaking tasks into smaller steps and maintaining clear communication with team members, I ensure all claims are processed accurately and on time without compromising quality.

To ensure accuracy, I double-check all entered data against source documents, such as prescriptions and insurance cards. I also use software features like auto-fill and validation checks to minimize errors. Regularly reviewing my work and staying focused during data entry helps me maintain high accuracy levels, which is crucial for preventing claim rejections and ensuring smooth billing operations.