Billing associate vs collections specialist

Differences between billing associate and collections specialist duties and responsibilities

Billing associate example responsibilities.

• Manage the submission and reimbursement of claims bill to insurance companies using ICD-9 coding.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Verify correct ICD-9 and CPT codes for a variety of specialties submission of electronic claims to clearinghouse.
• Ensure appropriate medical terminology and HIPAA compliance for all claims entry/online submissions, payment posting, insurance and patient aging.
• Help office transition from patient charts to new EMR system.
• Scan in all documents to EMR routing reports and labs to ordering physicians.
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Collections specialist example responsibilities.

• Manage university A/R processes and enforce tuition payment policy.
• Manage accounts for healthcare clients, review detailed patient information for payment resolution while abiding HIPPA privacy and security regulations.
• Review denied Medicare and Maine Medicaid insurance claims for accuracy.
• Analyze hospital insurance claims of individual patients for errors and contact major insurance carriers for claims dispute resolution.
• Analyze accounts for patients ineligible for private insurance, Medicare or Medicaid and indicating inability to pay balance.
• Possess effective persuasion and negotiation skills, excellent interpersonal and communications skills with the ability to deliver quality customer service.
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