Medical reimbursement specialist vs records specialist

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

• Develop numerous SQL scripts/queries for monitoring and managing the system.
• Manage thousands of cases for several firms with deadlines for depositions while ensuring accuracy, confidentiality, and HIPAA compliance.
• Train and mentore employees in EDMS.
• Process project records for retention in EDMS.
• Represent DOJ at an ODNI language training conference.
• Liaise with GIS group to resolve mapping issues.
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