Collections/accounts receivable vs billing representative

Differences between collections/accounts receivable and billing representative duties and responsibilities

Collections/accounts receivable example responsibilities.

• Plan and conduct sensitive HUMINT collection operations with an emphasis on managing and debriefing confidential sources.
• Work accounts receivable for Medicaid verification and payments.
• Work remittance advice from Medicaid ensuring accuracy of payments.
• Research and obtain extensive knowledge of FDCPA debt recovery laws and assist in recovering commercial debt from organizations.
• Communicate effectively with patients, physicians, hospital staff, and insurance representatives to ensure accuracy in claims processing.
• Review claims to determine if process correctly and if necessary, direct patients to contact insurance companies regarding additional benefit questions.
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Billing representative example responsibilities.

• Manage software programs for MSP accounts, monthly billing and EMC file transfers to Medicare.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Process orders in compliance with Medicare, Medicaid and private insurance verification guidelines; confirming customer's eligibility and insurance coverage.
• Verify insurance eligibility for schedule appointments, and verify cash pricing for private pay patients who request cost by CPT code.
• Submit and receive Medicare and Medicaid claims electronically on a daily basis.
• Utilize extensive computer skills and coding knowledge to produce and submit physical therapy and occupational therapy claims through medicaid and medicare.
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