Medical Collection Specialist

ShiftClicks; Miami (FL); Hybrid; USD 40,000 - 56,000; Full time

Benefits offered by this job

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

401k

Job summary

ShiftClicks is seeking a Medical Collection Specialist in Miami to manage billing and collections, with strong ICD10/CPT/HCPCS knowledge. Requires at least 1 year in billing or medical collections and proficiency with EHR/ECW systems.

Bilingual English/Spanish is preferred, with excellent communication and confidentiality skills. The role involves identifying denial trends, resubmitting claims, appealing denials, and coordinating with insurers to ensure timely payments.

Qualifications

• High School Diploma required.
• Minimum 1 year of billing/medical collections experience.
• ECW experience preferred; pathology billing experience noted.
• Bilingual English/Spanish preferred; reading/writing/speaking English required.

Responsibilities

• Identify denial trends and suggest resolutions.
• Process rejections/denials and resubmit claims as needed.
• Appeal denied claims and follow up.
• Answer billing questions from patients or insurers and resolve issues.
• Review patient information to determine denial causes.
• Communicate with insurers for claim payment and adjust balances.
• Maintain detailed chart notes in the system.
• Follow up on denials before payer appeal deadlines.

Skills

ICD10 coding

Communication skills

Organizational skills

Independent work

Confidentiality

Computer skills

Education

High School Diploma

Tools

ECW

EHR systems

MS Word

MS Excel

Job description

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 1 years of experience in billing and/or medical collections
• ECW experience preferred.
• Pathology Billing experience
• Bilingual English/Spanish Preferred; must be able to read, write and speak English.
• Computer Knowledge: MS word, MS Excel internet, document with Electronic Health Records and/or authorization system with minimal typing/spelling errors, send emails and faxes.

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.