Medical claims specialist vs specialist

Differences between medical claims specialist and specialist 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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Specialist example responsibilities.

• Create, manage, and assist users with SharePoint sites.
• Manage an on-site IRB and company good clinical practice (GCP) inspection.
• Manage SharePoint sites by creating, editing, and customizing company sites, libraries and security.
• Manage the building of accounts, assigning of static IP's, and scheduling of business class installations.
• Convert servers from UNIX to Linux, all hardware diagnostics and repair including printers/plotters/desktops etc.
• Follow safety procedures such as maintenance of all equipment (Telxon scanners, terminals and ladders).
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