Group billing coordinator vs claims coordinator

Differences between group billing coordinator and claims coordinator duties and responsibilities

Group billing coordinator example responsibilities.

• Set up, manage, and terminate ACH accounts.
• Work with case managers to obtain ICD-9 and CPT codes for qualify children.
• Perform coding and billing, including: ICD-9 and HCPCS coding for Medicare, AHCCCS, and Medi-Cal.
• Enter ICD-9 and HCPCS codes, file insurance claims (HCFA and UB04) both electronically and paper.
• Supervise daily activities of billing specialist by overseeing and reviewing coding procedures and diagnosis coding using CPT and ICD-9 codes.
• Prepare and submit appeals on deny claims with ADR and letter.
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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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