Medical claims specialist vs medical records technician

Differences between medical claims specialist and medical records technician 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.
Show more

Medical records technician example responsibilities.

• Enter all patient in-take into EMR, manage triage, scheduling, and maintain a sterile clinic setting.
• Manage medical treatment authorizations and durable medical equipment (DME) requests and verify medical eligibility for all patients requesting treatment.
• Perform examinations in the ER, main radiology area and surgery.
• Order medical records for patients, medical staff, outside entities, and court subpoenas for certain dates of services.
• Audited/Validate daily outpatient medical coding accounts involving emergency rooms, surgery, interventional radiology, radiology, and ancillary services.
• Staff education on EMR and industry regulations.
Show more