Medical reimbursement specialist vs reimbursement specialist

Differences between medical reimbursement specialist and reimbursement 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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Reimbursement specialist example responsibilities.

• Manage the EDI clearinghouse rejections.
• Process department payroll, order supplies, and manage petty-cash funds.
• Manage use of various systems, such as MEDITECH, Cerner, WebNow, and yield-base follow-up tool.
• Manage cases by aggressively directing the litigation process.
• Negotiate fee structure for manage care contracts on acute and rehabilitation facilities.
• Research medical coding ICD-9, ICD-10, HCPCS and CPT-4 to let client know the outcome of medical claim.
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