Patient access representative vs billing representative

Differences between patient access representative and billing representative duties and responsibilities

Patient access representative example responsibilities.

• Use EMR software to manage patient records and files; reinforce and uphold patient confidentiality as required by HIPPA and clinic.
• Conduct intensive screening of all Medicare, Medicaid and manage care patients for provider service eligibility.
• Educate eligible applicants about Medicaid manage care and how to access benefits in a manage care environment.
• Run internal reports to ensure ICD 9 and CPT procedure codes are accurate for billing for Medicare and Medicaid patients.
• Deliver quality customer service and compassion while obtaining demographic and financial data from patients seeking emergency medical services.
• Operate front desk check-in, preparation of charts, receive payments and balance books at the end of the day.
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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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