MPOWERHealth
Reimbursement Specialist
San Antonio, Texas•Full-time
About the Job
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
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.
- 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.