Medical reimbursement specialist vs medical billing clerk

Differences between medical reimbursement specialist and medical billing clerk 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 billing clerk example responsibilities.

• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Interact with patients as part of the quality assurance process (follow-up, EHR confirmation, billing confirmation).
• Reconcile insurance and patient payments while researching and resolving incorrect payments, EOB rejections, and assort issues with outstanding accounts.
• Utilize medical terminology and follow HIPAA guidelines.
• Bill Magellan through Nextgen system.
• Double checked CMS-1500 form before posting it out to the insurance companies.
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