Medicare billing specialist vs account representative

Differences between medicare billing specialist and account representative duties and responsibilities

Medicare billing specialist example responsibilities.

• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Resolve billing issues, ensure accuracy re: CPT, HCPCS, ICD-9 codes as applicable.
• Expand knowledge with insurance EOB & Tennessee Medicare (handle denials and some occurring problems )
• Call Medicare to re-open claims due to date, CPT, units, or other changes.
• Used CPT-4 coders/Modifiers, ICD-9 codes, HCPCS codes when applicable for the resolution of claim payments.
• Comply with all HIPPA laws.
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Account representative example responsibilities.

• Manage all billing accounts including Medicare/Medicaid, HMO and individual accounts.
• Manage the daily correspondence from assign practices with keeping doctor/patient confidentiality under consideration along with HIPPA regulations.
• Manage and maintain an internal database system to generate reports and produce accurate account information for patients and insurance companies.
• Educate physicians to use current ICD-9 diagnostic coding and preparation to begin ICD-10 coding requirements.
• Analyze health care insurance/litigation patient account files to resolve outstanding and delinquent accounts due to the healthcare client.
• Promote ThermoCool SmartTouch ablation catheter device to electrophysiologists.
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