I have over five years of experience in medical billing, with the last three years specifically focused on occupational medicine. My role involved processing claims for workplace injuries, ensuring compliance with workers' compensation regulations, and coordinating with healthcare providers and employers to facilitate accurate billing. I am proficient in using billing software tailored to occupational health services and have a strong understanding of the nuances in coding for occupational medicine, such as distinguishing between regular health insurance and workers' compensation claims.

I regularly attend workshops and webinars hosted by professional organizations like the American Academy of Professional Coders (AAPC) and the National Institute for Occupational Safety and Health (NIOSH). Additionally, I subscribe to industry newsletters and participate in online forums where billing specialists discuss updates and challenges. This proactive approach ensures I remain informed about the latest changes in ICD and CPT codes, as well as any adjustments in workers' compensation billing practices across different states.

In my previous role, I encountered a recurring discrepancy where certain services were being denied by workers' compensation insurers due to incorrect coding. Upon investigation, I realized the issue stemmed from a misunderstanding of the specific codes required for occupational therapy evaluations. I organized a training session for the billing team to clarify the correct coding practices and worked with the IT department to update our billing software's autofill suggestions. This initiative reduced claim denials by 30% within three months.

To ensure timely billing, I prioritize tasks based on submission deadlines and the urgency of the claim. I utilize calendar reminders and checklist systems within our billing software to track each step of the billing process. Additionally, I maintain open communication with healthcare providers to promptly address any missing information that could delay billing. This systematic approach has allowed me to consistently meet or exceed the 95% on-time submission rate required by my previous employer.

When facing a claim denial or dispute, I first review the denial reason in detail to understand the insurer's perspective. I then gather all necessary documentation, including medical records and treatment justifications, to support an appeal. If the denial is due to a coding error, I correct it and resubmit the claim promptly. For more complex disputes, I collaborate with the healthcare provider to provide additional evidence or clarification. My persistence and attention to detail have successfully overturned approximately 85% of denied claims in my experience.