CPB Certified Professional Biller Certification Practice Exam

Which of the following correctly describes the function of a health benefits advisor?

1. To diagnose medical conditions

2. To assist beneficiaries with healthcare related problems

3. To manage medical records

4. To handle payment disputes between providers

The correct answer is: To assist beneficiaries with healthcare related problems

The role of a health benefits advisor is primarily focused on assisting beneficiaries with healthcare-related issues. This includes guiding individuals through their health coverage options, helping them understand their benefits, and providing support in accessing necessary healthcare services. Health benefits advisors serve as a resource for beneficiaries to effectively navigate the complexities of health insurance, ensuring they receive the appropriate care and are informed of their coverage entitlements. In contrast, other options involve different functions that do not align with the specific role of a health benefits advisor. Diagnosing medical conditions is the responsibility of healthcare professionals, such as physicians. Managing medical records pertains to medical record technicians or administrative support staff who handle patient documentation rather than advising on benefits. Handling payment disputes between providers typically falls under the purview of billing specialists or financial representatives, not health benefits advisors, who focus more on the beneficiaries' understanding and utilization of their health plans.