Insurance biller vs medical claims processor

Differences between insurance biller and medical claims processor duties and responsibilities

Insurance biller example responsibilities.

• Use EMR software to manage patient records and files; reinforce and uphold patient confidentiality as required by HIPAA and clinic.
• Utilize ICD-9 and CPT codes, enter charges, and send statements for billing purposes.
• Process monetary transactions, insurance payments and enter into bookkeeping ledgers and monthly statements to patients.
• Submit medical claims for reimbursement on medical services provide to patients by medical provider for reimbursement.
• Code and post hospital and office charges using ICD-9, CPT-4.
• Look up ICD-9 codes to verify if a code has been change and enter.
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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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