Medical reimbursement specialist vs medical records technician

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

• Enter all patient in-take into EMR, manage triage, scheduling, and maintain a sterile clinic setting.
• Manage medical treatment authorizations and durable medical equipment (DME) requests and verify medical eligibility for all patients requesting treatment.
• Perform examinations in the ER, main radiology area and surgery.
• Order medical records for patients, medical staff, outside entities, and court subpoenas for certain dates of services.
• Audited/Validate daily outpatient medical coding accounts involving emergency rooms, surgery, interventional radiology, radiology, and ancillary services.
• Staff education on EMR and industry regulations.
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