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Specialist, Reimbursement

Mpoweringhealthcare · mpoweringhealthcare.com
San AntonioMid level2+ yrs
Apply on Mpoweringhealthcare’s site

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The job in short

Healthcare reimbursement.

ClinicalInsuranceLegal

Details

Found
15 d ago · posted 2024-10-19
Location as listed
San Antonio, TX, US
Role
Medical Coding / Billing / Records
Source
The company’s own careers site

Full description

Overview 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 Qualifications • 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 IND456

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