Medical Collection Specialist

Gastromed, LLC; Lorida (FL); Remote; USD 42,000 - 56,000; Full time

Job summary

Gastromed, LLC is seeking a Medical Collection Specialist to apply in-depth ICD10/HCPCS coding knowledge to medical billing, collections, and appeals. The role involves analyzing denials, submitting appeals, and communicating with patients and insurers to resolve billing issues.

The ideal candidate has 1+ year in medical billing/collections, experience with eClinicalWorks preferred, and bilingual English/Spanish abilities.

Qualifications

• High School Diploma required.
• Minimum one year of medical billing and/or medical collections experience.
• Remote candidates must reside and work within the State of Florida.
• Bilingual English/Spanish preferred; read, write, and speak English.

Responsibilities

• Identify denial trends and recommend 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 promptly.
• Review patient information to determine denial causes and communicate with insurers.
• Request correct adjustments to resolve outstanding balances.
• Maintain accurate chart notes in the system.
• Follow up on patient denials prior to payer appeals deadline.
• Perform other duties as assigned.

Skills

ICD10/HCPCS coding

Denial management

Communication

Multitasking

Independent work

Bilingual English/Spanish

Confidentiality

Education

High School Diploma

CPC Certified Preferred

eClinicalWorks (eCW) experience

Pathology billing experience

Tools

eClinicalWorks (eCW)

Job description

JOB TITLE: MedicalCollection 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.