Insurance clerk vs billing specialist

Differences between insurance clerk and billing specialist duties and responsibilities

Insurance clerk example responsibilities.

• Manage front office check-in, insurance verification and certifications from doctors.
• Establish and implement procedures for completion of patient super bills with proper diagnostic coding utilizing ICD-9 and CPT code manuals.
• Maintain patient medical records insuring diagnosis codes (ICD-9) are itemized correctly and name and address of insurance carriers record.
• Schedule and obtain authorization for outpatient procedures for patients via private insurance, worker's compensation, and Medicare/ Medicaid.
• Complete several ICD-10 training courses.
• Perform medical coding with most accurate and descriptive HCPCS code.
Show more

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.
Show more