Insurance assistant vs medical claims processor

Differences between insurance assistant and medical claims processor duties and responsibilities

Insurance assistant example responsibilities.

• Cold-Cal to generate leads for individual life and disability insurance and annuities.
• Analyze Medicaid models, Medicare and HIPAA transaction documents.
• Assign ICD-9 and CPT codes to office visit and inpatient and outpatient procedures.
• Process electronic claims, pre-existing and subrogation investigation, point of service, and PPO and HMO processing.
• Train staff on billing software in regards to CPT codes and pricing, submission procedures, and industry regulations.
• Perform verification of Medicare and Medicaid coverage and limits.
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Medical claims processor example responsibilities.

• Enter UB 92 and 1500 HCFA medical claims into computer system manage and process insurance claims.
• Manage cases by aggressively directing the litigation process.
• Submit medical claims to commercial insurance companies, Medicare, and Medicaid for payment with use of ICD-9 and CPT coding.
• Review and verify patient account information against insurance program specifications, analyze surgical procedures and diagnoses using CPT-4 and ICD-9 codes.
• Acknowledge and enforces confidentiality in alignment with (HIPPA) guidelines.
• Audit encounters and ICD-10 codes to ensure correct coding and maximum reimbursement.
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