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Medical Billing and Collections Expert

2 months ago

Miami, Florida, United States Gastromed, LLC Full time
Job Description

Job Title: 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 2 years of experience in Medical Billing and collections.
  • ECW experience preferred.
  • Pathology Billing experience.
  • Bilingual English/Spanish Preferred; must be able to read, write and speak English.
  • Computer Knowledge: MS word and MS Excel, internet, document with Electronic Health Records and/or authorization system with minimal typing/spelling errors, send e-fax and emails.

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.

Gastromed, LLC offers a competitive salary; Employee Health Insurance is covered at 100%. We also offer Dental, Vision, Life, and 401k Benefits.