I have over three years of experience in Medicare billing and coding, where I handled claims submission, verified patient eligibility, and ensured compliance with Medicare regulations. I am proficient in using billing software like Epic and have a strong understanding of CPT, ICD-10, and HCPCS codes. My attention to detail and knowledge of Medicare guidelines have consistently resulted in accurate claims and timely reimbursements.

When a claim is denied or rejected, I first review the explanation of benefits (EOB) to identify the issue. Common reasons include coding errors or missing information. I then correct the errors, gather necessary documentation, and resubmit the claim promptly. I also maintain a log of denied claims to track patterns and prevent future issues, ensuring compliance with Medicare policies.

I stay updated by regularly reviewing updates from the Centers for Medicare & Medicaid Services (CMS) website, attending webinars, and participating in professional development courses. I also subscribe to industry newsletters and collaborate with colleagues to discuss changes. This proactive approach ensures I remain compliant and can adapt quickly to new regulations.

To verify patient eligibility, I use the Medicare Administrative Contractor (MAC) portal or electronic eligibility verification tools. I confirm the patient’s coverage, effective dates, and any limitations. I also cross-check with the patient’s insurance card and demographic information. This thorough process ensures accurate billing and reduces the risk of claim denials.

I prioritize tasks by assessing urgency and deadlines. Claims nearing submission deadlines are addressed first, followed by resolving denied or rejected claims. I use task management tools to organize my workflow and set reminders for follow-ups. This systematic approach ensures timely processing and minimizes delays in reimbursement.