Billing representative vs registration representative

Differences between billing representative and registration representative duties and responsibilities

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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Registration representative example responsibilities.

• Work with third party payer requirements including Medicare, Medicaid (AHCCCS), manage care plans, and commercial plans.
• Manage and update demographic and insurance information, including authorizations and referrals, while demonstrating HIPPA confidentiality regulations.
• Verify eligibility and insurance benefits for patients, including Medicare, Medicaid, private insurance and workers' compensation.
• Maintain patient privacy in accordance with HIPAA with a high level of professionalism, compassion, productivity, and accuracy.
• Maintain proficient level of knowledge regarding Medicare requirements, HIPAA compliance and reimbursement criteria.
• Complete registration process for inpatients, outpatients, and emergency patients accurately and efficiently in accordance with policies and procedures.
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