I have over five years of experience in revenue cycle management within the healthcare sector, focusing on optimizing billing processes, ensuring compliance with healthcare regulations, and improving cash flow. My role involved conducting audits to identify discrepancies in billing and coding, implementing corrective actions, and training staff on best practices to minimize errors and enhance revenue collection.

I regularly attend workshops and seminars hosted by professional healthcare organizations like AHIMA and AAPC. Additionally, I subscribe to industry newsletters and participate in online forums to discuss updates in healthcare billing and coding regulations. This continuous learning approach ensures I remain knowledgeable about current standards and can apply them effectively in my audits.

During a routine audit, I discovered a recurring underbilling issue due to incorrect procedure codes being used, which was costing the organization approximately $50,000 monthly. I collaborated with the billing department to correct the codes, implemented a training program to prevent future errors, and established a more rigorous pre-submission review process, significantly improving revenue accuracy.

I employ a systematic approach that includes reviewing current laws and regulations, using standardized audit checklists, and leveraging software tools to flag potential compliance issues. I also prioritize clear communication with the billing and coding teams to ensure understanding and adherence to legal requirements, reducing the risk of non-compliance and associated penalties.

I approach disputes professionally by presenting clear, evidence-based findings and listening to the department head's perspective. I aim to foster a collaborative environment where we can discuss discrepancies openly and work together to develop a mutually acceptable resolution that aligns with organizational goals and compliance standards.