Self pay representative vs billing specialist

Differences between self pay representative and billing specialist 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 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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