Reimbursement Specialist (IOM)

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

Job Summary 

The Reimbursement Specialist is responsible for billing, collections, payment posting, appeals, data entry, phone calls, inquires, and other functions as assigned. 

Essential Job Duties and Responsibilities 

• 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 
• 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 
• Other duties as assigned 

Education and/or Experience 

• High School degree or equivalent 
• Minimum of 2-year Medical Collections Experience 

Skills/Specialized Knowledge 

• 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 of all above 

Other Requirements 

• Must maintain professional appearance.  
• Ability to be at work on a regular and consistent basis 

Physical and Mental Demands 

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.  

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