Specialist, Reimbursement

MPOWERHealthSan Antonio, TexasOn-siteFull-timeListed 2 hours ago

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About this role

Overview

About MPOWERHealth:

For over a decade, MPOWERHealth has supported the independent musculoskeletal physician with best-in-class clinical services, back-office solutions, and advanced technology. We pride ourselves on being a partner that offers foresight to customers. We simplify what’s complex, and we help them find a better way. Our best-in-class analytics coupled with industry-leading expertise make MPOWERHealth the company our customers can rely on no matter what lies ahead.

Benefits:

- Multiple medical plan options

- Health Savings Account with company contributions

- Dental & vision coverage for you and your dependents

- 401k with Company match

- Vacation, sick time & Company paid holidays

- Company wellbeing program with health insurance incentives

Responsibilities

ESSENTIAL WORK SKILLS/KNOWLEDGE & ABILITIES:

- Ability to appeal denied and deficient claims.

- Ability to spell, have good grammar, and can write an appeal letter.

- Ability to read & understand an EOB

- Participates in educational activities and reports needed information to Collections Manager.

- Contact and follow up with insurance carriers on denials, file reconsideration requests, formal appeals and negotiations

- Ability to organize and manage multiple priorities commitment to company values

Able to perform all essential duties with or without accommodations, including but not limited to:

- Aggressive follow up in collecting from insurance companies

- Skill in fast data entry and accuracy.

- High level of discretional, interpersonal skills.

- Tactfulness in dealing with patients, co-workers and other professional offices.

- Knowledge of medical terminology

- Interact with external/internal customers as necessary to resolve problems and expedite payments

- Obtain status of outstanding claims

- Problem Solving/Troubleshooting

- Follow-up on outstanding AR balances assigned by supervisor or manager

- Ensure timely and accurate processing of re-bills to the appropriate insurance companies

- Provide detailed information regarding problem payors to management

- Submit appeals based on denials from payor

- Provide suggestions for solutions to management

Qualifications

- Minimum of 2 year Medical Collections Experience

- Minimum High School Diploma required

- Knowledge of CPT, and/or ICD-10

- Knowledge of legal and regulatory government provisions

- Knowledge of laws that regulates communication and privacy act. HIPAA laws and understanding of the application

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