Claims account specialist vs claim specialist

Differences between claims account specialist and claim 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.

Claim specialist example responsibilities.

• Assist in the streamlining of EDI process to manage workflow of EDI claims.
• Manage claims on desk, route/queues, and ECHS within specify turn-around-time parameters.
• Manage claims, route/queues, and ECHS, within specify turn- around time parameters.
• Investigate, manage, negotiate and resolve claims arising out of accidents involving automobile and homeowner policies.
• Upgrade CPT-4 and ICD-9 coding procedures, staying in step with many manage care plans changing reimbursement schedules.
• Manage expedition of appeals via problem solving and collaboration with other departments.
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