In my previous role, I handled denial management by analyzing denied claims to identify root causes, such as coding errors or missing documentation. I collaborated with clinical and billing teams to rectify issues, ensuring compliance with payer requirements. I also implemented process improvements, like staff training and workflow adjustments, to reduce denial rates. My proactive approach included monitoring trends and addressing recurring issues, which improved claim acceptance rates by 15% over six months.

I ensure CDI aligns with regulations by staying updated on coding guidelines, such as ICD-10 and CPT, and payer-specific requirements. I conduct regular audits of clinical documentation to identify gaps and provide feedback to providers. Additionally, I facilitate training sessions to educate staff on accurate documentation practices. By fostering collaboration between coders, clinicians, and CDI specialists, I ensure documentation supports accurate coding, reduces denials, and complies with regulatory standards.

I improve communication by establishing regular interdisciplinary meetings to discuss denial trends, documentation issues, and process improvements. I also use shared dashboards to track key metrics, ensuring transparency. By fostering a collaborative environment, I encourage open dialogue and problem-solving. Additionally, I create standardized workflows and documentation templates to streamline communication and reduce errors, ensuring both teams work cohesively toward common goals.

I stay current by subscribing to industry newsletters, attending webinars, and participating in professional organizations like AHIMA or AAPC. I also review updates from CMS and major payers regularly. By networking with peers and attending conferences, I gain insights into best practices. This proactive approach ensures I adapt quickly to regulatory changes, minimizing compliance risks and maintaining accurate documentation and coding practices.

In a previous role, I reduced denial rates by 20% within a year by implementing a comprehensive denial management program. I analyzed denial trends, identified common issues like incomplete documentation, and provided targeted training to staff. I also streamlined workflows and introduced pre-submission audits to catch errors early. By collaborating with clinical and billing teams, I ensured timely resolution of denied claims and improved overall revenue cycle performance.