Billing specialist vs insurance verification specialist

Differences between billing specialist and insurance verification specialist duties and responsibilities

Billing specialist example responsibilities.

• Use of QuickBooks to manage vendors' accounts, set up filing system to maintain files and supporting billing documents.
• Manage the daily correspondence with keeping doctor/patient confidentiality under consideration along with HIPPA regulations.
• Use independent judgment, manage and impart confidential information appropriately per HIPAA regulations and company requirements.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Provide additional information/clarification for insurance claims using knowledge of CPT, ICD-9, and HCPCS codes, as well as modifiers.
• Assist staff with proper billing for patients, ensure proper coding using ICD-10, ICD-9 and CPT-4 coding.
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Insurance verification specialist example responsibilities.

• Check CPT and ICD-10 codes with LCD and policies from multiple insurance companies to make sure procedures will be paid.
• Support the patient privacy/confidentiality policies and regulations under HIPAA for patients and their medical records.
• Confirm correct charges base on HCPCS codes.
• Assist callers as well with questions about their benefits, terms and conditions of medical plans, appeals and grievances.
• Provide medical record support in the absence of EMR: assist clinics and hospitals in obtaining medical records in appropriate format.
• Document outbound communication from providers and veterans.
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