Medicare billing specialist vs reimbursement specialist

Differences between medicare billing specialist and reimbursement specialist 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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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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