- 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
- Ability to work with insurance carriers to negotiate claims processing and payments
- Ability to appeal denied and deficient claims
- Contact and follow up with insurance carriers on denials, file reconsideration requests, formal appeals and negotiations.
- Ability to understand EOB's, insurance payments, and adjustments
- Responsible for helping review insurance denials related to diagnosis issue
- Participates in educational activities and reports needed information to leadership
- Ability to spell, have good grammar, and be able to write a business letter.
- Provide suggestions for solutions to management
- Obtain status of outstanding claims
- Provide detail information regarding problem payors to management
- Other duties as assigned
- High School degree or equivalent
- Minimum of 2 years of medical collections experience (Out of Network, strongly preferred)
- Knowledge of CPT, and/or ICD-9
- Knowledge of legal and regulatory government provisions
- Knowledge of laws that regulates communication and privacy act. HIPPA laws and understanding of the application of all above
- Aggressive follow up with insurance carriers on claims with accepted negotiation agreements
- 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
- Must maintain professional appearance.
- Ability to be at work on a regular and consistent basis
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Specialist, Negotiations - San Antonio, United States - Mpower Healthcare
Description
OverviewAbout MPOWERHealth:
For over a decade, MPOWERHealth has supported the independent musculoskeletal physician with best-in-class clinical services, back-office solutions, and advanced technology.
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:
Job Summary
The Negotiations Specialist is responsible for appealing and negotiating denied or deficient claims. The position requires superior communication and computer skills.
Essential Job Duties and Responsibilities
Education and/or Experience
This position will spend long hours sitting and using office equipment and computers.
The position may also entail light lifting of supplies and materials occasionally, up to and including 20 pounds in addition to reaching, stooping, standing, and walking.
This position requires the ability to talk, hear, compare, compute, compile, copy, analyze, coordinate, synthesize, negotiate and communicate. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.Work Environment
Standard office working environment that may be busy and noisy at times.
Responsibilities JobSummary The Negotiations Specialist is responsible for appealing and negotiating denied or deficient claims. The position requires superior communication and computer skills.
EssentialJobDutiesandResponsibilities - Ability to work with insurance carriers to negotiate claims processing and payments - Ability to appeal denied and deficient claims - Contact and follow up with insurance carriers on denials, file reconsideration requests, formal appeals and negotiations.
- Ability to understand EOB's, insurance payments, and adjustments - Responsible for helping review insurance denials related to diagnosis issue - Participates in educational activities and reports needed information to leadership - Ability to spell, have good grammar, and be able to write a business letter.
- Provide suggestions for solutions to management - Obtain status of outstanding claims - Provide detail information regarding problem payors to management - Other duties as assigned
Specialist, Negotiations professionals in San Antonio
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Jaime Contreras, MBA, CISM, CISA
IT Security Specialist