CPB (Certified Professional Biller) Certification Practice Exam

Who is the person responsible for preparing and reviewing claims for accuracy to ensure prompt payment?

1. Health Insurance Specialist

2. Independent Contractor

3. Medical Ethics

4. BlueCard Program

The correct answer is: Health Insurance Specialist

The correct choice is the Health Insurance Specialist. This individual plays a vital role in the healthcare billing process by preparing and reviewing claims to ensure they are accurate and complete. Their expertise helps facilitate prompt payment from insurance companies, which is crucial for maintaining the financial health of healthcare organizations. Health Insurance Specialists are trained to understand coding, billing guidelines, and regulations, allowing them to identify any errors or discrepancies before a claim is submitted. This proactive approach minimizes delays in payment and reduces the chances of claim denials, ultimately leading to more efficient revenue cycle management. The other options do not fit the description of the role directly related to preparing and reviewing claims. An Independent Contractor could potentially perform tasks similar to those of a Health Insurance Specialist, but their role is not specifically focused on the claims review process. Medical Ethics refers to principles governing moral conduct in medicine and does not pertain to billing. The BlueCard Program is a health insurance program that facilitates access to care for beneficiaries traveling across state lines, but it is not an individual responsible for preparing claims.