Medicare specialist vs billing specialist

Differences between medicare specialist and billing specialist duties and responsibilities

Medicare specialist example responsibilities.

• Manage cases by aggressively directing the litigation process.
• Submit correct claims when appropriate, assigning ICD-9-CM, CPT, HCPCS, and / or service codes when necessary.
• Maintain HIPPA compliance with all communications.
• Obtain accurate ICD-9 codes and process completed CMN's.
• Include knowledge of ICD-9 codes and state fee schedules/usual and customary.
• Code claims using the CPT and ICD-9-CM coding systems appropriate at the time.
Show more

Billing specialist example responsibilities.

• Use of QuickBooks to manage vendors' accounts, set up filing system to maintain files and supporting billing documents.
• Manage the daily correspondence with keeping doctor/patient confidentiality under consideration along with HIPPA regulations.
• Use independent judgment, manage and impart confidential information appropriately per HIPAA regulations and company requirements.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Provide additional information/clarification for insurance claims using knowledge of CPT, ICD-9, and HCPCS codes, as well as modifiers.
• Assist staff with proper billing for patients, ensure proper coding using ICD-10, ICD-9 and CPT-4 coding.
Show more