I have extensive experience in revenue cycle management, having worked with insurance companies and healthcare providers to resolve claim denials. My role involved analyzing denial reasons, drafting appeal letters, and ensuring compliance with payer guidelines. I successfully reduced denial rates by 20% in my previous position through effective communication and thorough documentation.

I prioritize tasks based on the urgency of the appeal and the potential financial impact on the organization. I use a ticketing system to track each case and set deadlines accordingly. This ensures that high-priority cases are addressed promptly while still managing the workload efficiently.

I ensure successful appeal outcomes by thoroughly researching each case, understanding the payer's guidelines, and presenting a clear, concise argument. I also collaborate with the billing team to gather necessary documentation and ensure all information is accurate and complete before submitting the appeal.

I maintain clear and professional communication with insurance companies and other stakeholders by being proactive in addressing issues, providing detailed explanations, and following up as needed. I also document all communications to ensure a transparent and traceable record of the appeal process.

In a previous role, I faced a denial due to incorrect coding. I worked closely with the coding team to correct the error, gathered additional documentation, and submitted a detailed appeal. The insurance company reversed the denial, resulting in a significant reimbursement for the provider.