Medicare specialist vs medical records clerk

Differences between medicare specialist and medical records clerk 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 records clerk example responsibilities.

• Manage transition from in-house transcription system to outsource transcription service.
• Manage front office check-in, insurance verification and certifications from doctors.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Perform infant labs and update the system with results, triage incoming patients, perform necessary resuscitation to baby and mom.
• Provide information to medical facilities and patients when necessary and respond to subpoenas and other general release of patient information.
• Experience in CPT and ICD-10 coding.
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