Medical reimbursement specialist vs health information specialist

Differences between medical reimbursement specialist and health information specialist duties and responsibilities

Medical reimbursement specialist example responsibilities.

• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Review and submit medical documentation for medical claims appeals as necessary.
• Review and assign ICD-9, CPT-4 and HCPCS, and correct E/M codes to each patient encounter to prevent recovery credits.
• Verify private medical insurance benefits and Medicaid eligibility.
• Follow up on unpaid/unresolve account balances, including claims reject electronically and EOB denials.
• Research account activity base on analysis reports and correspondence resulting in additional follow-up with patients, insurance carriers and referring physicians.
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Health information specialist example responsibilities.

• Manage chart completion (ICD-9-CM and CPT coding/abstracting), chart assembly and analysis, patient admission and patient information privacy/security.
• Review and audit medical records for correct DRG and APC assignment.
• Certify requests for subpoenas, court orders, legal cases and training of employees.
• Utilize Cerner and Centricity systems to assist in ancillary services.
• Abstract medical records with ICD9-CM, CPT and DRG coding.
• Scan documentation via DCS into HPF to be index under ROI.
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