Specialist, Reimbursement

Us-Tx-San Antoniomid

Other

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Quick Summary

Key Responsibilities

Ability to appeal denied and deficient claims. Ability to spell, have good grammar, and can write an appeal letter.

Technical Tools

Other

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.

What We Offer

~1 min read

✓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

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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

Requirements

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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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