Insurance specialist vs insurance clerk

Differences between insurance specialist and insurance clerk 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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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.
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