Billing consultant vs billing representative

Differences between billing consultant and billing representative duties and responsibilities

Billing consultant example responsibilities.

• Manage software programs for MSP accounts, monthly billing and EMC file transfers to Medicare.
• Register incoming patients, verify demographics as well as insurance verification.
• Research and determine the viability of collections on all Medicaid accounts receivables.
• Audit EMR system and correct ICD-9 coding errors.
• Review EOB's, and apply payments to the patient's accounts, making applicable adjustments.
• Contact insurance carrier directly, review eob's, reviewing medical records, denials, write appeals.
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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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