Medical Collection Specialist

Gastromed, LLC; Tallahassee (FL); Hybrid; USD 42,000 - 60,000; Full time

Benefits offered by this job

Health Insurance

Dental

Vision

Life Insurance

401k

Competitive salary

Job summary

Gastromed, LLC is seeking a Medical Collection Specialist to manage ICD10 and HCPCS coding, CMS 1500 form processing, and electronic claims submission. The role requires attention to denial trends, strong communication with patients and insurers, and adherence to confidentiality.

Remote work may be available for Florida residents; familiarity with eClinicalWorks is a plus. The candidate should have at least a year in medical billing or collections, with a high school diploma, and bilingual

Qualifications

• ICD10 and HCPCS coding knowledge required.
• Billing/collections experience in medical setting preferred.
• Bilingual English/Spanish preferred; read/write/speak English.

Responsibilities

• Identify denial trends and recommend resolutions.
• Process rejections/denials and resubmit claims.
• Appeal denied claims and follow up as needed.
• Answer billing questions from patients or insurers.
• Review patient information to identify denial causes.
• Communicate with insurance companies for claim payments.
• Request adjustments to resolve outstanding balances.
• Maintain detailed chart notes in the system.
• Follow up on denials before payer appeal deadlines.
• Perform other duties as assigned.

Skills

ICD10 coding

HCPCS coding

Communication

Customer service

Organizational skills

Independent work

Confidentiality

PC skills

Education

High School Diploma

CPC Certified Preferred

Tools

eClinicalWorks (eCW)

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 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.