In my previous role, I encountered a reimbursement issue involving multiple insurance carriers with different claim submission requirements. I meticulously reviewed each carrier's guidelines, reconciled discrepancies in submitted claims, and coordinated with the billing department to resubmit corrected claims. This proactive approach not only resolved the issue but also improved our claim submission accuracy, resulting in a 15% increase in successful reimbursements.

I ensure accuracy and compliance by maintaining a thorough understanding of current healthcare regulations and reimbursement policies. I regularly update my knowledge through industry publications and training sessions. Additionally, I utilize automated tools for data validation and conduct regular audits of processed claims to identify and rectify any errors promptly, ensuring all reimbursements are processed correctly and in compliance with industry standards.

To manage high volumes efficiently, I prioritize claims based on urgency and complexity, using a ticketing system to track progress. I also leverage software that automates routine tasks, freeing up time for more intricate analyses. Regular team meetings ensure alignment and swift resolution of any bottlenecks. This structured approach maintains high throughput while ensuring each claim is handled with the necessary attention to detail.

When discrepancies arise, I first conduct a detailed review of the claim submission and the payer's response. I then reach out to the payer for clarification, using clear, concise communication to expedite resolution. If necessary, I escalate the issue to higher authorities within the payer organization. Post-resolution, I document the findings and share insights with the team to prevent future occurrences, enhancing our overall reimbursement accuracy.

I have extensive experience with various reimbursement software, including Epic, Cerner, and Meditech. When adapting to new systems, I first familiarize myself with the software's features and capabilities through training modules and user manuals. I then apply this knowledge to real-world scenarios, collaborating with the IT team to address any technical issues. This proactive approach ensures a smooth transition and optimal utilization of the new system, enhancing my efficiency and effectiveness in processing reimbursements.