Referral specialist vs patient care specialist

Differences between referral specialist and patient care specialist duties and responsibilities

Referral specialist example responsibilities.

• Manage assignments of paying medical bills limit in depth that include organizing and researching regulations as pertain to veterans eligibility.
• Interview patients, evaluate eligibility, collect co-pays, deductibles, including, but not limit to insurance verification.
• Input HIPAA information, call physician offices to verify testing, collect copay's and deductibles.
• Arrange for debt repayments or establish repayment schedules and send out insurance claims with the correct ICD-9 and CPT codes.
• Research referrals and either deny or approve based on information obtain and appropriately identify diagnosis (CPT and ICD-9 coding).
• Maintain confidentiality by following all applicable HIPAA regulations.
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Patient care specialist example responsibilities.

• Use EMR software to manage patient records and files; reinforce and uphold patient confidentiality as required by HIPAA and clinic.
• Utilize software applications to document call interactions using medical terminology and responsible for initially engaging patients by explaining the services.
• Verify CPT codes along with diagnosis code for guarantee payment for surgeries.
• Process daily fee tickets and correctly enter office visit ICD 9 and CPT codes into the system for billing.
• Adhere to HIPPA confidentiality guidelines.
• Track Medicaid eligibility of clients.
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