Claims coordinator vs insurance biller

Differences between claims coordinator and insurance biller duties and responsibilities

Claims coordinator example responsibilities.

• Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
• Process and adjust Medicare claims, provide feedback to providers on proper CPT, ICD-9 coding for billing purposes.
• Serve as point of contact for all legal issues relate to HIPAA.
• Streamline audit procedures of TPA and maintain extremely high production rate which help in keeping staffing requirements lower.
• Review and audit claims -Using correct CPT and DX codes -Denial reports -correct billing error, resubmitted claims for proper payment
• Communicate with company management, injure workers/customers, medical providers and TPA, as necessary, regarding claim relate matters.
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Insurance biller example responsibilities.

• Use EMR software to manage patient records and files; reinforce and uphold patient confidentiality as required by HIPAA and clinic.
• Utilize ICD-9 and CPT codes, enter charges, and send statements for billing purposes.
• Process monetary transactions, insurance payments and enter into bookkeeping ledgers and monthly statements to patients.
• Submit medical claims for reimbursement on medical services provide to patients by medical provider for reimbursement.
• Code and post hospital and office charges using ICD-9, CPT-4.
• Look up ICD-9 codes to verify if a code has been change and enter.
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