Insurance billing clerk vs billing specialist

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

• Use of QuickBooks to manage vendors' accounts, set up filing system to maintain files and supporting billing documents.
• Manage the daily correspondence with keeping doctor/patient confidentiality under consideration along with HIPPA regulations.
• Use independent judgment, manage and impart confidential information appropriately per HIPAA regulations and company requirements.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Provide additional information/clarification for insurance claims using knowledge of CPT, ICD-9, and HCPCS codes, as well as modifiers.
• Assist staff with proper billing for patients, ensure proper coding using ICD-10, ICD-9 and CPT-4 coding.
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