Specialist, Reimbursement

4 weeks ago


San Antonio Texas, United States MPOWERHealth Full time
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. HIPPA laws and understanding of the application of a



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