I have extensive experience with medical insurance billing and coding, having worked with various insurance providers and healthcare systems. I am proficient in using billing software like Epic and Cerner, and I stay updated with the latest coding standards such as ICD-10 and CPT. My role involves ensuring accurate and timely submission of claims, resolving billing discrepancies, and maintaining compliance with insurance regulations.

When handling patient inquiries about their insurance coverage, I first gather all necessary information about their policy and the specific service they are inquiring about. I then review their benefits and limitations, and explain the details in a clear and understandable manner. If additional information is needed from the insurance provider, I follow up promptly to ensure the patient receives accurate and timely responses.

To manage and reduce claim denials, I implement a proactive approach by thoroughly reviewing each claim before submission to ensure all necessary information is included and accurate. I also maintain strong communication with insurance providers to understand their specific requirements and stay updated on any policy changes. Additionally, I conduct regular audits of past claims to identify common errors and implement corrective actions to prevent future denials.

In a fast-paced environment, I prioritize tasks by assessing their urgency and impact on patient care and financial outcomes. I use tools like to-do lists and calendars to organize my workload and set daily goals. I also communicate regularly with my team to ensure we are aligned on priorities and can provide mutual support when needed. This approach helps me manage multiple tasks efficiently and maintain high-quality service.

In a previous role, I encountered a situation where a patient's claim was repeatedly denied due to a coding error. I worked closely with the patient, the healthcare provider, and the insurance company to gather all relevant documentation and correct the coding. I also escalated the issue to a supervisor when necessary. After several follow-ups and clarifications, the claim was finally approved, and the patient received the coverage they needed. This experience reinforced the importance of persistence and clear communication in resolving complex insurance issues.