In my previous role, I managed reimbursement processes by coordinating with insurance companies, healthcare providers, and patients. I ensured accurate billing, timely submission of claims, and resolved discrepancies. My experience includes using software like Epic and Meditech to track claims and payments. I also maintained detailed records and communicated effectively with stakeholders to ensure compliance with regulations. My focus was always on maximizing revenue while maintaining high levels of customer satisfaction.

To ensure accuracy, I meticulously review all documentation, including patient records, insurance details, and billing codes. I cross-check data against internal systems and verify compliance with payer requirements. I also stay updated on coding standards and regulatory changes. Additionally, I implement double-checking procedures and use automated tools to flag potential errors. My attention to detail and systematic approach minimize errors and ensure that claims are processed correctly the first time.

When dealing with denied or rejected claims, I first analyze the reason for denial by reviewing the explanation of benefits (EOB) or remittance advice. I then gather necessary documentation, such as medical records or corrected billing codes, and resubmit the claim promptly. If the issue persists, I escalate it to the appropriate department or contact the payer directly. My goal is to resolve issues efficiently to minimize revenue loss and ensure timely reimbursement.

I prioritize tasks based on deadlines and complexity, using tools like spreadsheets and reimbursement software to track progress. I maintain a structured filing system for both digital and physical documents. Regular check-ins with team members help me stay aligned with organizational goals. I also set aside time daily to review pending tasks and address urgent issues. By staying proactive and organized, I ensure that high-volume workloads are managed effectively without compromising accuracy.

I stay informed by subscribing to industry newsletters, attending webinars, and participating in professional development courses. I also network with peers and join professional organizations like HFMA or AAPC. Regularly reviewing updates from CMS and other regulatory bodies ensures I remain compliant. By staying current, I can adapt processes to meet new requirements and minimize risks for the organization.