Job Description
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 PreferredABILITIES / 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 CheckWe offer a competitive salary; Employee Health Insurance is covered at 100%. We also offer Dental, Vision, Life, and 401k Benefits.