Medical reimbursement specialist vs medical records clerk

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

• Manage transition from in-house transcription system to outsource transcription service.
• Manage front office check-in, insurance verification and certifications from doctors.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Perform infant labs and update the system with results, triage incoming patients, perform necessary resuscitation to baby and mom.
• Provide information to medical facilities and patients when necessary and respond to subpoenas and other general release of patient information.
• Experience in CPT and ICD-10 coding.
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