MPowerHealth

EMPOWERed Careers.

Reimbursement Specialist

Job Details

Job Ref:
391065

Location:
San Antonio, TX 78248

Category:
Medical Billing and Coding

Department:
MPOWERHealth

Overview

GENERAL SUMMARY:

We are a fast growing medical billing company looking for a positive person who is interested in being a success and will help take the company to the next level. The seasoned professional for this job needs superior communication and computer skills including familiarity, with Microsoft Outlook, Word and Excel. This individual will be responsible for billing, collections, appeals, data entry, phone calls, inquires, and other functions as assigned by the Reimbursement Supervisor and/or Manager.

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

Requirements

Skills and Abilities:

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

Experience and Training:

  • 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 all above

IND123

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