I have over three years of experience in medical billing and coding, where I worked extensively with ICD-10, CPT, and HCPCS coding systems. My role involved verifying patient information, submitting claims to insurance companies, and resolving discrepancies. I am proficient in using billing software like Epic and Medisoft, and I have a strong understanding of insurance policies and reimbursement processes. My attention to detail ensures accurate coding, which minimizes claim denials and maximizes revenue for the healthcare facility.

When a claim is denied or rejected, I first review the denial reason provided by the insurance company. I then cross-check the patient’s records, coding, and billing details to identify any errors. After correcting the issue, I resubmit the claim promptly. If the denial is due to a policy issue, I communicate with the insurance provider to clarify and resolve the matter. My goal is to ensure timely reimbursement while maintaining compliance with billing regulations.

To ensure compliance, I stay updated on healthcare regulations such as HIPAA, CMS guidelines, and state-specific billing laws. I regularly review billing processes to identify potential compliance risks and implement corrective measures. I also conduct internal audits to verify the accuracy of coding and billing practices. Additionally, I provide training to staff on compliance-related updates to ensure the entire team adheres to regulatory standards.

I prioritize tasks by assessing the urgency and impact of each account. Claims nearing deadlines or those with high reimbursement values are addressed first. I use task management tools to organize my workflow and set reminders for follow-ups. Effective communication with the team also helps in delegating tasks when necessary. This approach ensures that all accounts are managed efficiently without compromising accuracy or timelines.

To reduce claim denials, I focus on accurate coding and thorough verification of patient and insurance information before submitting claims. I also conduct regular audits to identify common denial patterns and address them proactively. Training staff on best practices and staying updated on payer-specific requirements further minimizes errors. By implementing these strategies, I have successfully reduced claim denials and improved revenue cycle performance.