Insurance collector vs billing specialist

Differences between insurance collector and billing specialist duties and responsibilities

Insurance collector example responsibilities.

• Verify accuracy of claims, work EOB's for all insurance company types, identify and solve problems with unpaid claims.
• Handle workers' comp., HMO, PPO correspondence.
• Identify incorrect charges base on proper CPT coding and payment methodologies.
• Utilize ICD9 and CPT code medical directories for billing purposes to get paid on claims.
• Perform necessary task to have commercial and workers comp EOB's reprocess to receive the correct total reimbursement.
• Download weekly Florida Medicaid remittance amounts and send to management.
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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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