Claims account specialist vs billing specialist

Differences between claims account specialist and billing specialist duties and responsibilities

Claims account specialist example responsibilities.

• Manage accounts for healthcare clients, review detailed patient information for payment resolution while abiding HIPPA privacy and security regulations.
• Interview incoming patients, his/her relatives, or other responsible individuals to obtain identifying and biographical information with insurance and financial information
• Review HMO insurance vouchers and resubmitted if necessary.
• Utilize excellent communication and negotiation skills to resolve credit card delinquency favorable to company and card member.

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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