Reimbursement analyst vs medical records clerk

Differences between reimbursement analyst and medical records clerk duties and responsibilities

Reimbursement analyst example responsibilities.

• Cultivate relationships with key contacts at insurance companies and manage care organizations, CMS and medical professional societies.
• Contract interpretation and enforcement of the agreement with multiple medical insurance companies through written and oral appeals is accomplished daily.
• Coordinate third party audits, defend preferential reporting practices and maintain current knowledge of Medicare and Medicaid reimbursement regulations.
• Update Meditech charge master with correct pharmacy pricing and HCPCS codes.
• Provide overall follow-up and coordination with Medicare and Medicare HMO plans and process with Medicare and Medicare HMO adjustments.
• Train on and implement eClinicalworks for several physician practices, taking them live from paper to full electronic medical records.
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Medical records clerk example responsibilities.

• Manage transition from in-house transcription system to outsource transcription service.
• Manage front office check-in, insurance verification and certifications from doctors.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Perform infant labs and update the system with results, triage incoming patients, perform necessary resuscitation to baby and mom.
• Provide information to medical facilities and patients when necessary and respond to subpoenas and other general release of patient information.
• Experience in CPT and ICD-10 coding.
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