Senior billing analyst vs insurance billing clerk

Differences between senior billing analyst and insurance billing clerk 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.
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Insurance billing clerk example responsibilities.

• Manage the patient education program, responsible for ensuring patients are fully educate regarding medical conditions and prescribe medications.
• Accept and process healthcare claims and confidential medical records; verify patient eligibility and manage the Medicare and Medicaid billing process.
• Receive knowledge of CPT and ICD-9 codes used for insurance billing purposes.
• Verify Medicaid insurance eligibility prior to dispensing patient's orders.
• Maintain direct responsibility for contacting both patients and insurance carriers in a timely matter regarding ineligibility.
• Submit secondary insurance after primary has paid and submit EOB's with insurance forms.
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