Self pay representative vs billing representative

Differences between self pay representative and billing representative duties and responsibilities

Self pay representative example responsibilities.

• Contact patients to coordinate payment arrangements or update their demographics from return mail.
• Work 90-120 days, as well as older A/R.
• Bill accounts to various commercial insurances or Medicaid.
• Review EOB to assure that correct adjustments are satisfied.
• Process and follow up on appeals to insurance companies.
• Process all subpoena and attorney requests using extensive knowledge of HIPAA requirements.
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Billing representative example responsibilities.

• Manage software programs for MSP accounts, monthly billing and EMC file transfers to Medicare.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Process orders in compliance with Medicare, Medicaid and private insurance verification guidelines; confirming customer's eligibility and insurance coverage.
• Verify insurance eligibility for schedule appointments, and verify cash pricing for private pay patients who request cost by CPT code.
• Submit and receive Medicare and Medicaid claims electronically on a daily basis.
• Utilize extensive computer skills and coding knowledge to produce and submit physical therapy and occupational therapy claims through medicaid and medicare.
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