Receptionist/billing clerk vs billing specialist

Differences between receptionist/billing clerk and billing specialist duties and responsibilities

Receptionist/billing clerk example responsibilities.

• Assist office management and staff with administrative projects/responsibilities such as managing time-sensitive projects, filing, copying, and collating materials.
• Obtain and track all insurance referrals for patients with HMO products.
• Coordinate in-processing of all patients, to include accurate insurance information and payments are entered correctly into office computer system.
• Move from SNF billing to HMO outpatient billing and keep a large alpha current.
• Maintain confidentiality and adherence to HIPAA guidelines.
• Develop effective billing strategies for Medicaid recipients according to HIPPA rules and regulations.
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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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