Specialist, Reimbursement

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