Claim processing specialist vs client care specialist

Differences between claim processing specialist and client care 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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Client care specialist example responsibilities.

• Use EMR software to manage patient records and files; reinforce and uphold patient confidentiality as required by HIPAA and clinic.
• Credential new physicians, clinics and triage centers with Medicare/Medicaid and major insurance plans for territory.
• Assign to cable company supporting cable products, schedule installation appointments and troubleshoot issues with customers in a call center environment
• Conduct teleconferences, schedule customer reservations and maintain teleconferencing database.