Medical Records Specialist - Conshohocken, PA

MPOWERHealthConshohocken, PA
Onsite

About The Position

Join MPOWERHealth as a Reimbursement Specialist – Where Your Skills Drive Healthcare Forward! Are you a natural problem-solver who thrives on turning challenges into opportunities? Do you enjoy collaborating with a passionate team and making a direct impact on healthcare providers' success? If so, your next great opportunity is here at MPOWERHealth! For over a decade, MPOWERHealth has empowered independent musculoskeletal physicians with cutting-edge clinical services, back-office solutions, and advanced technology. We simplify the complex, anticipate challenges, and guide our clients toward a brighter future. With our innovative analytics and expert teams, we transform obstacles into opportunities.

Requirements

  • High school diploma or GED equivalent required.
  • 1-2 years of medical collections/medical office experience.
  • Intermediate level of expertise using Microsoft Office Suite (Outlook, Excel, Word, Teams) and PDF software (NitroPro).
  • Familiarity with insurance payer rules and regulations.
  • Ability to effectively multi-task.
  • Strong comprehensive and analytical skills.
  • Effective verbal and written communication skills including professional phone skills.
  • Detail-oriented.
  • Able to function as a cooperative team member with a positive attitude.
  • Must have ability to work independently with minimal supervision and maintain confidentiality.

Responsibilities

  • Respond to medical record requests from insurance carriers at varying stages of claim processing to ensure maximum reimbursement from each claim.
  • Navigate the electronic medical record (EMR) and revenue platform to obtain, produce, and transmit required records to insurance carriers or third parties.
  • Demonstrate understanding of explanations of benefits (EOBs) and respond appropriately to denials and medical insurance correspondence.
  • Comprehend revenue-based and claim lifecycle account notes, and maintain clear and concise notation/documentation.
  • Understand and comply with all governmental, regulatory, company billing/AR, and compliance regulations/policies assigned by payers.
  • Analyze EOBs and correspondence to construct medical record packages that accurately respond to requests/claim adjudications.
  • Identify and communicate specific payer information, issues, and/or trends to appropriate parties/departments.
  • Follow up and complete tasks on pending accounts in a timely manner.
  • Address denials and zero payments to identify and provide any requested documentation required to process the claim or refer to billing for claim corrections.
  • Utilize office equipment and software applications to facilitate claim finalization.
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