Claim processing specialist vs specialist

Differences between claim processing specialist and 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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Specialist example responsibilities.

• Create, manage, and assist users with SharePoint sites.
• Manage an on-site IRB and company good clinical practice (GCP) inspection.
• Manage SharePoint sites by creating, editing, and customizing company sites, libraries and security.
• Manage the building of accounts, assigning of static IP's, and scheduling of business class installations.
• Convert servers from UNIX to Linux, all hardware diagnostics and repair including printers/plotters/desktops etc.
• Follow safety procedures such as maintenance of all equipment (Telxon scanners, terminals and ladders).
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