Hospital insurance representative vs senior specialist

Differences between hospital insurance representative and senior 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.

Senior specialist example responsibilities.

• Manage the JSC QMS system.
• Lead special projects, train and mentore lean sigma teams.
• Manage capacity planning activities for UAT and production environment.
• Manage coordination, implementation and installation of next generation telemarketing system, an nt-base, client server environment.
• Assist in the setup of the Documentum ACLs for WPS & QA and WPS, such that duplication doesn't occur.
• Maintain awareness of HIPAA, SOX, GLB and other regulatory statues ensuring compliance within the work group.
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