I have over three years of experience in Medicaid billing and coding, where I was responsible for ensuring accurate claim submissions, resolving denied claims, and staying updated with Medicaid regulations. My role required meticulous attention to detail to avoid errors that could lead to claim rejections. I am proficient in using billing software and have a solid understanding of ICD-10 and CPT codes, which are essential for accurate Medicaid billing.

I stay updated with Medicaid policies and regulations by subscribing to relevant newsletters, attending webinars, and participating in professional development courses. I also regularly visit the official Medicaid website and engage in forums where professionals discuss updates and share insights. This proactive approach ensures I am always informed about changes that could impact billing processes and compliance requirements.

Once, I encountered a situation where multiple claims were denied due to an unrecognized provider number. After investigating, I discovered the issue was due to a system update that had not been properly communicated. I coordinated with the IT department to correct the provider numbers in our system and resubmitted the claims. I also implemented a checklist to verify provider information before submission, preventing future occurrences. This experience highlighted the importance of thorough verification and effective problem-solving in billing.

To ensure timely submission of Medicaid claims, I prioritize tasks based on deadlines and set reminders for upcoming due dates. I also batch process claims to improve efficiency and conduct regular audits to identify and address any delays in the billing cycle. Communication with the healthcare providers is key to obtaining necessary documentation promptly, ensuring that all claims are submitted within the required timeframe.

When handling denied or rejected Medicaid claims, I first analyze the denial reason to understand the issue. I then gather all necessary documentation and make the required corrections or provide additional information as needed. I maintain a log of common denial reasons to identify patterns and implement preventive measures. Persistence and attention to detail are crucial in successfully appealing denied claims and ensuring reimbursement.