I have extensive experience with pharmacy billing systems such as RxClaim, Change Healthcare, and Availity. I am proficient in processing claims, managing denials, and ensuring compliance with HIPAA regulations. My background includes troubleshooting errors, optimizing billing processes, and collaborating with insurance companies to resolve discrepancies.

When discrepancies or errors occur, I first identify the root cause, whether it's a coding issue, missing information, or a system error. I then communicate with the appropriate parties, such as insurance providers or internal teams, to resolve the issue promptly. I also document the resolution to prevent future occurrences and maintain accurate records.

I prioritize thoroughness and attention to detail in all billing tasks. I regularly review billing procedures to identify potential areas for improvement and implement best practices. Additionally, I maintain open communication with the pharmacy team and insurance providers to ensure all claims are processed efficiently and accurately.

I regularly attend industry webinars, read professional publications, and participate in training sessions to stay informed about changes in billing regulations and insurance policies. I also collaborate with colleagues and industry groups to share knowledge and ensure compliance with the latest standards.

In a previous role, I encountered a situation where a high volume of claims were being denied due to a new insurance policy change. I worked closely with the insurance provider to understand the policy and updated our internal processes to align with the new requirements. This proactive approach resulted in a significant reduction in claim denials and improved overall billing efficiency.