Medicare correspondence representative vs billing representative

Differences between medicare correspondence representative and billing representative duties and responsibilities

Medicare correspondence representative example responsibilities.

• Manage CMS communications throughout the organization.
• Follow specific HIPAA guidelines as set forth by company regulations.
• Maintain, update, and review member files adhering to strict HIPPA guidelines.
• Send high volume of written correspondence/affirmation letters to providers and patients.
• Provide professional and confidentiality with patient information due to HIPPA regulations.
• Assist with data reports by comparing enrollment error reports against system information along with CMS records to validate information accuracy.
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Billing representative example responsibilities.

• Manage software programs for MSP accounts, monthly billing and EMC file transfers to Medicare.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Process orders in compliance with Medicare, Medicaid and private insurance verification guidelines; confirming customer's eligibility and insurance coverage.
• Verify insurance eligibility for schedule appointments, and verify cash pricing for private pay patients who request cost by CPT code.
• Submit and receive Medicare and Medicaid claims electronically on a daily basis.
• Utilize extensive computer skills and coding knowledge to produce and submit physical therapy and occupational therapy claims through medicaid and medicare.
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