I have over three years of experience in medical insurance billing and collections, where I managed accounts receivable, resolved claim denials, and ensured timely payments from insurance companies. I am proficient in using billing software like Epic and have a strong understanding of CPT and ICD-10 coding. My role required me to communicate effectively with insurance providers and patients to resolve discrepancies, ensuring compliance with HIPAA regulations. I consistently met collection targets and improved cash flow for my previous employer.

When handling denied or rejected claims, I first review the explanation of benefits (EOB) to identify the reason for denial. I then verify the accuracy of the claim, including patient information, coding, and documentation. If errors are found, I correct and resubmit the claim promptly. For issues like missing information or policy violations, I contact the insurance company or the patient to resolve the matter. My goal is to ensure claims are processed efficiently, minimizing delays in payment and maintaining positive relationships with both insurers and patients.

I prioritize tasks by assessing the urgency and impact of each account. High-priority tasks, such as resolving denied claims or addressing overdue accounts, are handled first. I use organizational tools like spreadsheets and task management software to track deadlines and progress. Additionally, I maintain clear communication with team members to ensure alignment on priorities. By staying organized and proactive, I ensure that all accounts are managed effectively, reducing the risk of missed deadlines or unresolved issues.

I ensure compliance with HIPAA and other regulations by strictly adhering to privacy and security protocols. This includes safeguarding patient information, using secure systems for data storage and transmission, and only sharing information on a need-to-know basis. I stay updated on regulatory changes through continuous education and training. Additionally, I conduct regular audits of my work to identify and address potential compliance risks. By maintaining a strong focus on compliance, I protect patient confidentiality and uphold the integrity of the organization.

When discussing unpaid balances with patients, I approach the conversation with empathy and professionalism. I clearly explain the charges, provide detailed billing statements, and offer payment options or financial assistance programs if available. I listen to the patient's concerns and work collaboratively to find a solution that meets their needs while ensuring the organization receives payment. By maintaining a respectful and understanding tone, I build trust and encourage patients to fulfill their financial obligations.