Specialist, Reimbursement - San Antonio, United States - Mpower Health

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    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 whats 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. HIPPA laws and understanding of the application of a