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.