What are the responsibilities and job description for the Medical Collection Specialist position at Gastromed, LLC?
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.