Account resolution specialist vs billing representative

Differences between account resolution specialist and billing representative duties and responsibilities

Account resolution specialist example responsibilities.

• Manage accounts for healthcare clients, review detailed patient information for payment resolution while abiding HIPPA privacy and security regulations.
• Research and resolve complex customer accounts while adhering to department policies and procedures, as well as FDCPA guidelines.
• Resolve outstanding patient accounts by an integrate team dynamic with office administrators, insurance companies and patients.
• Insure office practices are in compliance with HIPAA regulations.
• Review and correction of diagnosis codes, CPT codes and modifiers.
• Advise clients/debtors of necessary actions and strategies for debt repayment while using FDCPA and other government regulations.
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Billing representative example responsibilities.

• Manage software programs for MSP accounts, monthly billing and EMC file transfers to Medicare.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Process orders in compliance with Medicare, Medicaid and private insurance verification guidelines; confirming customer's eligibility and insurance coverage.
• Verify insurance eligibility for schedule appointments, and verify cash pricing for private pay patients who request cost by CPT code.
• Submit and receive Medicare and Medicaid claims electronically on a daily basis.
• Utilize extensive computer skills and coding knowledge to produce and submit physical therapy and occupational therapy claims through medicaid and medicare.
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