Claim processing specialist vs retention specialist

Differences between claim processing specialist and retention 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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Retention specialist example responsibilities.

• Save customer relationship by managing and exceeding TWC goals.
• Prepare proposals and analysis for county Medicaid facilitators to educate regarding available manage care programs.
• Increase revenue through up-selling and cross-selling video, HSI, wireless, and telephony services to existing customers.
• Provide advance troubleshooting of wireless broadband, IP services, PC's, wireless routers.
• Process payments via CSG and ICOMS.
• Provide rep support, assist with account flow, escalation, reschedule, expedites, construction/survey.
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