Medical Collection Specialist

  JOB TITLE:       Medical Collection Specialist     REPORTS TO:  Revenue Cycle Manager  FLSA STATUS: Non-Exempt                                                          JOB SUMMARY:  In-depth knowledge of Procedural Coding, Specialist in identifying appropriate ICD10 coding based on CMS/HCC categories, CPT, HCPCS CMS 1500 FORM, Super Bill, Electronic Claims Submission and Clearing House Operations, EOB, Payments, Denials, and appeals.  QUALIFICATIONS/EDUCATION: * High School Diploma required. * Minimum one (1) year of experience in medical billing and/or medical collections. * Experienced candidates may be considered for a remote work arrangement. Remote candidates must reside and work within the State of Florida. * eClinicalWorks (eCW) experience preferred. * Pathology billing experience preferred. * Bilingual English/Spanish preferred; must be able to read, write, and speak English. CERTIFICATIONS/LICENSES: * CPC Certified Preferred  ABILITIES/SKILLS: * In depth knowledge of ICD10 and HCPCS coding. * Excellent communication, Customer Service and telephone skills. * Strong organizational skills and ability to multi-task effectively.  * Must be able to work independently with minimal supervision. * Able to respect and maintain patient confidentiality at all times. Functions with minimal direct supervision. * Must be dependable and conduct him/herself in a professional manner. * Demonstrates skill in use of personal computers, various programs and applications required to competently execute job duties. * Must be able to follow policies and procedures.   ESSENTIAL DUTIES/ RESPONSIBILITIES:  * Identify denial trends and make recommendations for resolutions.   * Process rejections/denials and resubmit claims as needed. * Appeal denied claims and follow up as needed. * Answer patients’ or insurers’ billing questions and resolve issues or disputes in a timely manner. * Review patient information to determine or identify claim denial causes.   * Communicate with insurance companies for claim(s) payment. * Request correct adjustment to resolve outstanding account balances. * Maintain accurate and detailed chart notes in the system. * Follow- up on patient denials prior to the payer’s appeal deadline. * Perform any other duties as assigned. PRE-EMPLOYMENT REQUIREMENTS * Criminal Background Check We offer a competitive salary; Employee Health Insurance is covered at 100%. We also offer Dental, Vision, Life, and 401k Benefits.