Medical claims specialist vs medical record assistant

Differences between medical claims specialist and medical record assistant duties and responsibilities

Medical claims specialist example responsibilities.

• Apply Medicare, Medicaid billing guidelines to achieve maximum reimbursement.
• Detail knowledge of medical coding; ICD-9, CPT and HCPCS codes.
• Confirm coverage and work with private payers, commercial payers, Medicaid, and Medicare for reimbursement of provide medical services.
• Research medical records, compliance requirements and explanations of benefits to resolve accounts payable for Medicare, Medicaid and commercial insurance.
• Maintain strict confidentiality/privacy of patients' protect health information in accordance with HIPAA regulations.
• Assist in educating new hires in HIPPA laws and training.
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Medical record assistant example responsibilities.

• Lead special department-wide task force initiative to minimize abuse of Oxycontin prescriptions bill to Medicaid.
• Manage and organize all paperwork concerning caregivers and patients; organize filing system; ensure operation of electronic filing systems.
• Work with EHR, provide medical records to patients and specialty centers.
• Guide department through transition from paper charts to EHR system scan all patient records into database.
• Scan documents into electronic medical records system and certify HIPAA compliance
• Implement HIPAA guidelines in keeping patient information secure and confidential.
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