Reimbursement Specialist - MPOWERHealth
San Antonio, TX 78248
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
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
- 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.
It is the policy of MPOWERHealth not to discriminate against any applicant for employment, or any employee because of age, color, sex, disability, national origin, race, religion, or veteran status.
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