In my previous role, I encountered a situation where a provider submitted a claim with incorrect coding. I had to review the medical records, consult with the provider, and correct the coding to ensure the claim was processed correctly. This required strong attention to detail and effective communication to resolve the issue promptly.

I prioritize tasks based on deadlines and the complexity of the issues. Urgent claims with shorter deadlines are addressed first, followed by more complex cases that require detailed review. I also use a ticketing system to track progress and ensure nothing falls through the cracks.

I follow a multi-step verification process, including double-checking coding, verifying patient eligibility, and reviewing the entire claim before submission. I also stay updated on any changes in reimbursement policies and train regularly to maintain high accuracy standards.

When faced with a denial, I first review the reason provided by the insurance company. I then gather all necessary documentation, including medical records and prior authorizations, and submit an appeal. I maintain clear communication with the provider and patient throughout the process to ensure they are informed and supported.

I have experience with various reimbursement software systems, including Epic, Cerner, and Meditech. I am proficient in navigating these platforms to process claims, track payments, and generate reports. My ability to adapt to new systems quickly allows me to contribute effectively in any environment.