Medical billing specialists are vital for the efficient management of all aspects of billing. A medical billing specialist’s responsibilities can include: expert management of healthcare billing-processing, adjusting and resubmitting of claims; adherence to current healthcare industry regulations and policies; and compliance with insurance procedures and allotted benefit coverage. Billing specialists understand the information on identification cards, distinguish between Medicare and Medicaid and understand Blue Cross/Blue Shield coverage and workers ’ compensation benefits.
A claims analyst uses the same skills as a billing specialist. The duties of a claims analyst may include: overseeing claims processing and payments to third-party providers, monitoring charges and verifying correct payment of claims, sending denial letters on claims and sending follow-up requests for information. The claims analyst reviews payment reports for accuracy and compliance.
Medical billing specialists/claims analysts can work in hospitals, insurance companies, doctors’ offices, medical billing companies, nursing homes, medical group practices, home health agencies and medical clinics.
Students who complete this shorter term Medical Billing/Claims Analyst program can go to work and return at any time to complete the Medical Office Specialist AAS degree.
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Medical Billing/Claims Analyst