Medical reimbursement specialist vs medical biller coder

Differences between medical reimbursement specialist and medical biller coder 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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Medical biller coder example responsibilities.

• Manage chart completion (ICD-9-CM and CPT coding), chart assembly and analysis and patient information privacy/security.
• Use EMR software to manage patient records and files reinforce and uphold patient confidentiality as required by HIPAA and clinic.
• Manage chart completion (ICD-9-CM and CPT coding/abstracting), chart assembly and analysis, patient admission and patient information privacy/security.
• Bill insurance claims using HCFA 1500 and UB-92 form.
• Review coding, verify the diagnosis codes (ICD-9) and procedure codes (CPT) are congruent and clinically appropriate.
• Have experience in all commercial insurances and government insurances including Medicare and Medicaid.
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