I have over five years of experience in Medicare and Medicaid billing. I am proficient in navigating CMS guidelines, processing claims, and ensuring compliance with state and federal regulations. My experience includes working with electronic health records (EHR) systems, managing denials, and coordinating with insurance companies to resolve billing issues.

When handling denials and rejections, I first review the reason codes provided by the payer. I then work to correct any errors or omissions in the claim, such as missing information or coding inaccuracies. I resubmit the corrected claim and follow up to ensure it is processed promptly. Additionally, I document all actions taken to prevent future denials.

To improve cash flow and reduce AR days, I prioritize follow-up on outstanding claims, especially those nearing the 90-day mark. I also ensure timely submission of claims and maintain clear communication with patients regarding their financial responsibilities. Regularly reviewing and updating billing practices to address common issues can also help streamline the process.

I stay updated on changes in Medicare and Medicaid regulations by regularly reviewing CMS updates, attending industry webinars, and participating in professional associations. I also subscribe to relevant newsletters and journals to ensure I am informed about any policy changes that may impact billing practices.

I have extensive experience with various electronic billing systems and software, including those compliant with HIPAA standards. I am proficient in using EHR systems to extract billing data, submit claims electronically, and manage patient accounts. My experience also includes troubleshooting technical issues and training staff on system usage.