Medical Collections Specialist

Help us accelerate the growth of our expanding medical services facility ! We are looking for an experienced Medical Collections Specialist to expand our Revenue Cycle Team and assist in collecting payments for physician and diagnostic surgical procedures to ensure effective cash receipts. We operate a Medicaid/Medicare clinic with 19 specialty departments and 71 providers in a fast-paced and ever-changing environment that requires fast thinking, outstanding organization skills and exceptional verbal communication skills.

Overview of Job Functions and Duties:

Follow-up on open and pending insurance claims to ensure collection within insurance company time limits.

Prepare and submit insurance claim appeal letters.

Contact patients regarding monies owed.

Understand the charge entry process with the proper ICD 10 codes for testing and procedures.

Ensure proper provider is being billed and provider participates in the plan.

Knowledge of Medicaid manual submission through EPACES for one position required

Knowledge of Worker's Comp submission and follow up for one position required

Maintain confidentiality and adhere to HIPAA and other regulations.

Education and Experience:

High school diploma (college degree a plus).

3+ years of experience in medical billing and collections with a billing company or healthcare facility in insurance claims and patient A/R follow-up.

Skills, Knowledge, and Abilities:

Well versed in CPT and ICD-10 codes, procedural modifiers, claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits and appeal processes.

Proficient in EMR software and Microsoft Word, Excel and Outlook.

Skilled in medical billing database and EHR systems.

Emdeon and Change Healthcare knowledge a plus.

Follow-up experience with insurance companies and patients for complete claims processing and maximum payment.

Familiarity with commercial insurance carriers, Medicare, PPO, HMO, Workers Compensation, No-Fault carriers and their guidelines.

Work effectively in a team environment.

Strong ability to identify, analyze and solve problems.

Self-motivated and approach tasks with a positive, proactive demeanor.

Organized and detail-oriented.

Ability to communicate effectively in writing, over the telephone, and in person in Spanish and English

WE DO NOT TRAIN FOR THIS POSITION. YOU WILL BE ADMINISTERED A TEST TO VERIFY YOUR KNOWLEDGE.

INTERVIEW WILL BE IN SPANISH.