Medical care evaluation specialist vs reimbursement specialist

Differences between medical care evaluation specialist and reimbursement specialist duties and responsibilities

Medical care evaluation specialist example responsibilities.

• Apply Medicare, Medicaid billing guidelines to achieve maximum reimbursement.
• Retrieve specific records and documents for emergency room, critical care unit, medical surgery and cardiology departments.
• Coordinate with interdisciplinary team members to ensure MDS complete accurately and timely for submission and subsequent reimbursement.

Reimbursement specialist example responsibilities.

• Manage the EDI clearinghouse rejections.
• Process department payroll, order supplies, and manage petty-cash funds.
• Manage use of various systems, such as MEDITECH, Cerner, WebNow, and yield-base follow-up tool.
• Manage cases by aggressively directing the litigation process.
• Negotiate fee structure for manage care contracts on acute and rehabilitation facilities.
• Research medical coding ICD-9, ICD-10, HCPCS and CPT-4 to let client know the outcome of medical claim.
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