Payment processor vs billing specialist

Differences between payment processor and billing specialist duties and responsibilities

Payment processor example responsibilities.

• Manage and review all incoming discounts and electronic contractual adjustments for accuracy per the negotiated Medicaid and Medicare contracts ;.
• Maintain daily transactions for customer payments and various bank accounts using Quickbooks to track transactions.
• Prepare and print all reports for EDI processing.
• Maintain client customer confidentiality and HIPAA regulations with all data handling and transfers.
• Uphold and reinforce compliance with hospital policies and federal regulations such as HIPAA.
• Investigate and take corrective action regarding invoices reject by system or through EDI.
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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.
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