Insurance billing clerk vs billing representative

Differences between insurance billing clerk and billing representative 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 representative example responsibilities.

• Manage software programs for MSP accounts, monthly billing and EMC file transfers to Medicare.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Process orders in compliance with Medicare, Medicaid and private insurance verification guidelines; confirming customer's eligibility and insurance coverage.
• Verify insurance eligibility for schedule appointments, and verify cash pricing for private pay patients who request cost by CPT code.
• Submit and receive Medicare and Medicaid claims electronically on a daily basis.
• Utilize extensive computer skills and coding knowledge to produce and submit physical therapy and occupational therapy claims through medicaid and medicare.
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