Medical collections specialist vs payment processor

Differences between medical collections specialist and payment processor duties and responsibilities

Medical collections specialist example responsibilities.

• Manage accounts for healthcare clients, review detailed patient information for payment resolution while abiding HIPPA privacy and security regulations.
• Job duties include collecting on HMO, PPO, Medicare, and HMO Medicaid.
• Work directly with Medicare and HMO Medicaid plans, and statewide HMO/PPO/POS plans.
• Reprocess denied medical claims using extensive appeal tactics or special appeals processing instructions for commercial and government carriers.
• Adhere to all HIPAA guidelines as well as various policies and guidelines.
• Provide itemized billing statements and screen HIPAA authorization forms for hundreds of legal firms.
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Payment processor example responsibilities.

• Manage and review all incoming discounts and electronic contractual adjustments for accuracy per the negotiated Medicaid and Medicare contracts ;.
• Maintain daily transactions for customer payments and various bank accounts using Quickbooks to track transactions.
• Prepare and print all reports for EDI processing.
• Maintain client customer confidentiality and HIPAA regulations with all data handling and transfers.
• Uphold and reinforce compliance with hospital policies and federal regulations such as HIPAA.
• Investigate and take corrective action regarding invoices reject by system or through EDI.
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