Medicare specialist vs medical coder

Differences between medicare specialist and medical coder 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.
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Medical coder example responsibilities.

• Manage all EDI relate communication with trading partners and assist to produce all operational documents for all end users.
• Manage all aspects of AR including writing letters for medical necessity, claim denials, bundling issues and charge capture.
• Manage health records while applying ICD-10 coding to update and process insurance claims for time and accuracy to various insurance companies.
• Manage the outsourced transcription company.
• Create documentation education classes to general surgery residents, increasing the leveling of reporting which lead to increase revenues.
• Adhere to regulations with CPT-4, ICD-9-CM and HCPCS coding with medical terminology and effort meet all audit requirements.
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