Reimbursement specialist vs revenue specialist

Differences between reimbursement specialist and revenue specialist duties and responsibilities

Reimbursement specialist example responsibilities.

• Manage the EDI clearinghouse rejections.
• Process department payroll, order supplies, and manage petty-cash funds.
• Manage use of various systems, such as MEDITECH, Cerner, WebNow, and yield-base follow-up tool.
• Manage cases by aggressively directing the litigation process.
• Negotiate fee structure for manage care contracts on acute and rehabilitation facilities.
• Research medical coding ICD-9, ICD-10, HCPCS and CPT-4 to let client know the outcome of medical claim.
Show more

Revenue specialist example responsibilities.

• Process account receivables, charge entry, claims, and reimbursement in adherence to Medicare and all HMO guidelines.
• Establish a strong understanding of ICD-9 diagnosis and medical inventory codes.
• Work claim edits to ensure clean claim billing to Medicare/Medicare HMO's.
• Review the complex medical records and accurately codes primary/secondary diagnoses and procedures using ICD-10-CM and CPT coding conventions.
• Initiate appeals and ensure required documentation are submitted in the appeals process.
• Complete appeals when authorization are not obtain and or unusual procedure are performed.
Show more