Specialist, Reimbursement

MPOWERHealth•San Antonio, TX

About The Position

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

Requirements

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

Responsibilities

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