Hospital insurance representative vs contracts specialist

Differences between hospital insurance representative and contracts specialist duties and responsibilities

Hospital insurance representative example responsibilities.

• Cold-Cal to generate leads for individual life and disability insurance and annuities.
• Verify that each CPT code are paid correctly and according to fee schedule for any overpayment or underpayment ..
• Provide financial counseling for patients and their families by explaining financial policies and providing available resources for alternative payment.
• Fill out refund form with copy of all relate EOB's when credit balances are find on account.
• Serve as a resource/ advocate to all employees regarding claims problem resolution, benefits explanations and EOB issues.
• Collect patient demographic & insurance information via telephone for outpatient surgery and radiology.

Contracts specialist example responsibilities.

• Manage multiple task orders in an IDIQ environment.
• Provide clarity on medical and drug cover benefits for a Medicare advantage insurance plan.
• Manage inventory and distribution activities of the third-party logistics provider.
• Develop marketing strategies to expand Medicaid manage care provider network and enrollment.
• Manage the influenza vaccine annual contracting and RFP process for a national specialty pharmaceutical distributor.
• Process purchase orders and subcontracts, including managing insurance requirement compliance and certify payroll documentation.
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