Insurance billing clerk vs billing administrator

Differences between insurance billing clerk and billing administrator duties and responsibilities

Insurance billing clerk example responsibilities.

• Manage the patient education program, responsible for ensuring patients are fully educate regarding medical conditions and prescribe medications.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Receive knowledge of CPT and ICD-9 codes used for insurance billing purposes.
• Verify Medicaid insurance eligibility prior to dispensing patient's orders.
• Maintain direct responsibility for contacting both patients and insurance carriers in a timely matter regarding ineligibility.
• Submit secondary insurance after primary has paid and submit EOB's with insurance forms.
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Billing administrator example responsibilities.

• Manage facility procedures relate to insurance and billing and solve patients' queries regarding their insurance renewal and expiry.
• Perform coding of inpatient/outpatient office, endoscopy, & pathology services and ensure proper assignment of ICD-9 and CPT codes.
• Experience with CMS FISS systems.
• Coordinate HCPC and ICD-9 codes for billing.
• Reconcile JDE invoicing reports to CMS invoicing reports.
• Implement corporate or departmental policies, HIPAA compliance, and service standards in conjunction with clinical and billing.
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