Diligent Denial Specialist with extensive knowledge in medical billing processes and healthcare administration. Proven track record of ensuring accurate claim submissions and timely reimbursement. Known for effective communication and problem-solving skills, consistently meeting needs of healthcare providers.
Strong Points. Submitting underpayment appeals for any underpayments using the Payment Integrity Compass system for 1st level reconsiderations and payer contracts for 2nd Level reconsideration /Appeals. Gathering and submitting additional information for downgrades of DRGs, Lower level care CPTs, coding denials, etc. Following up on payment retractions and recoupment/offset. Identifying unposted payments. following up on medical records request, Authorization follow ups, attention to Detailed follow up calls which includes the insurance name and phone number, rep i spoke to along with call ref number, if I obtained info through automated system, portal, status of the account, if i refer the account to anyone or another dept etc....