Claim processing specialist vs center specialist

Differences between claim processing specialist and center specialist duties and responsibilities

Claim processing specialist example responsibilities.

• Manage expedition of appeals via problem solving and collaboration with other departments.
• Provide consumer-oriented health benefit plans, process all types of health claims knowledgeable of ICD-9 and CPT codes.
• Process medical claims for Medicaid recipients via a state-fund Medicaid insurance carrier per plan guidelines and department procedures.
• Ensure all work processes are compliant with various HIPAA regulations.
• Train on how to utilize reference materials to determine diagnosis, CPT, or appropriate HCPCS codes for claims processing.
• Provide speeches, educational information to various veterans organizations.
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Center specialist example responsibilities.

• Manage and troubleshoot applications and printers across exchange servers.
• Retain knowledge for xerox printers as well as microsoft office.
• Maintain supplies in the CPC and canvass weekly to keep sales high.
• Sort checks in order of bank of first deposit and encode ACH debits.
• Provide new POS (point of sale) system training for stores within the district.
• Adhere to the Weill Cornell procedures, NYPH policies and procedures, OSHA regulations and HIPAA guidelines
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