What are the responsibilities and job description for the Specialist, Reimbursement position at MPOWERHealth?
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
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