Medical Collection Specialist

Gastromed, LLC•Pinecrest, FL

51d

About The Position

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.

Requirements

High School Diploma required.
Minimum 1 years of experience in billing and/or medical collections
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.
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.

Nice To Haves

ECW experience preferred.
Pathology Billing experience
CPC Certified Preferred

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.