Senior billing analyst vs billing representative

Differences between senior billing analyst and billing representative duties and responsibilities

Senior billing analyst example responsibilities.

• Lead the requirement gathering effort from key customers for development of new JAVA applications and for troubleshooting customer issues.
• Range of knowledge in CPT, ICD-9, HCPCS codes and other billing standards.
• Forecast, prepare, and analyze cash flow, DSO, and bad debt reserve
• Monitor compliance to corporate financial and legal policies and (Sarbanes-Oxley law) SOX compliance.
• Maintain invoice files and supporting documentation as required for audits and in accordance with SOX requirements.
• Prepare certification of medical necessity and prior authorization forms for Medicaid reimbursement and follow through on appeals when applicable.
Show more

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.
Show more