Insurance specialist vs billing specialist

Differences between insurance specialist and billing specialist duties and responsibilities

Insurance specialist example responsibilities.

• Manage database by processing renewals and endorsements.
• Maintain confidentiality and adhere HIPPA guidelines with handling patients' information
• Make recommendations on operationalization and oversight of specific marketplace enrollment policies.
• Verify various health insurance plan benefit information and eligibility for patients with chronic illnesses.
• Identify third party patient eligibility for Medicaid, Medicare, private insurance and alternate resources.
• Enter and prepare advanced beneficiary notices base on diagnosis and procedure codes for Medicare cover patients.
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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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