Medical insurance biller vs authorization specialist

Differences between medical insurance biller and authorization specialist duties and responsibilities

Medical insurance biller example responsibilities.

• Manage all aspects of AR including writing letters for medical necessity, claim denials, bundling issues and charge capture.
• Work on computer systems Laserfiche and MedFm
• Update patient demographic and create new accounts in AS400.
• Address student's concerns, work with academic and attendance appeals boards.
• Download and organize charts from hospital's website into Laserfiche before coding.
• Require the ability to read and analyze EOB's from all insurance companies.
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Authorization specialist example responsibilities.

• Demonstrate knowledge of HIPAA by appropriately managing patient confidentiality.
• Utilize CMS and InterQual criteria to establish authorizations for members requiring medical services for a Medicare advantage insurance company.
• Build authorization, match ICD-10 codes with there procedure codes
• Provide patients with patient registration forms in order to follow up on patient check-in and check-out utilizing a proprietary management system.
• Obtain verification of insurance coverage and authorizations for clinical visits and surgical procedures for patients.
• Perform all components of the office registration including arrival, check-in and future appointments.
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