Patient relations representative vs billing representative

Differences between patient relations representative and billing representative duties and responsibilities

Patient relations representative example responsibilities.

• Assist with patient inquiries, release of information, while maintaining HIPAA regulation.
• Ensure patient's HIPAA regulations are being meet by hospital staff.
• Conduct family interviews for financial aid, Medicaid or discounts to family income status.
• Collect demographic information for new and establish patients and loads it into an automate registration/ scheduling system.
• Register new patients and updates existing patient demographics by collecting detail patient information including personal and financial information.
• Obtain all necessary documentation prior to surgery such as proof of identification, copy of insurance and require insurance referrals.
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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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