MPOWERHealth

Integrated spine care networks and neuromonitoring

Reimbursement Specialist

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeSan Antonio, TX, USANo salary listedIn-person

About the Job

Requirements

A high school diploma or GED equivalent is required.
At least 2 years of medical collections experience is required.
Intermediate-level expertise using Microsoft Office Suite, including Outlook, Excel, Word, and Teams, and PDF software such as NitroPro is required.
Familiarity with insurance payer rules and regulations is required.
The ability to multitask effectively is required.
Strong comprehensive and analytical skills are required.
Effective verbal and written communication skills, including professional phone skills, are required.
The candidate must be detail-oriented.
The candidate must be able to function as a cooperative team member with a positive attitude.
The candidate must be able to work independently with minimal supervision and maintain confidentiality.

Responsibilities

Understand and comply with all governmental, regulatory, company billing, accounts receivable, and compliance regulations and policies assigned by payers.
Analyze explanations of benefits and construct responses to insurance carriers based on claim adjudication.
Follow up with payers and other appropriate parties to collect open balances in a timely manner and ensure compliance with payer guidelines.
Identify and report payer issues regarding rejection trends, denial trends, or changes in payments, and communicate specific payer information to appropriate parties or departments.
Address denials and zero payments by identifying and providing requested documentation required to process claims, or refer claims to billing for corrections.
Follow up on and complete tasks for pending accounts in a timely manner until each account is settled.
Use office equipment and software applications to facilitate claim finalization.

Desired Qualifications

Previous experience working with multi-state practices.
Previous out-of-network experience.

Overview

Role Summary: Performs a variety of AR activities and related tasks in order to recognize the maximum reimbursement from each claim. This position will be responsible for navigating the electronic medical record (EMR) and billing systems to obtain/produce and transmit the records required by the applicable insurance carrier or third party. Demonstrates understanding of explanation of benefits (EOBs) and ability to digest and respond appropriately to denials and correspondence. Clear and concise notation/documentation is paramount to success in the role.

Responsibilities

Responsibilities:

Understand and comply with all governmental, regulatory, company billing/AR and compliance regulations/policies assigned by payers
Analyze EOBs and construct responses to insurance carriers based on claim adjudication.
Follow up with payers and other appropriate parties to collect open balances in a timely manner and to ensure compliance with payer guidelines
Identify and report payer issues regarding rejection trends, denial trends, or change in payments. Communicate specific payer information to appropriate parties/departments
Address denials and zero payments to identify and provide any requested documentation required to process the claim or refer to billing for claim corrections
Follow up and complete tasks on pending accounts in a timely manner until account is settled.
Use of office equipment and software applications to facilitate finalization of claim

Join MPOWERHealth as a Reimbursement Specialist – Where Your Skills Drive Healthcare Forward!Are you a natural problem-solver who thrives on turning challenges into opportunities? Do you enjoy collaborating with a passionate team and making a direct impact on healthcare providers' success? If so, your next great opportunity is here at MPOWERHealth!

Why Choose MPOWERHealth?For over a decade, MPOWERHealth has empowered independent musculoskeletal physicians with cutting-edge clinical services, back-office solutions, and advanced technology. We simplify the complex, anticipate challenges, and guide our clients toward a brighter future. With our innovative analytics and expert teams, we transform obstacles into opportunities.

Qualifications

Qualifications/Education/Experience:

High school diploma or GED equivalent required.

2+ years of medical collections experience required.
Intermediate level of expertise using Microsoft Office Suite (Outlook, Excel, Word, Teams) and PDF software (NitroPro)
Familiarity with insurance payer rules and regulations
Ability to affectively multi-task
Strong comprehensive and analytical skills
Effective verbal and written communication skills including professional phone skills
Detail-oriented.
Able to function as a cooperative team member with a positive attitude.
Must have ability to work independently with minimal supervision and maintain confidentiality.

Other:

Previous experience working with multi-state practices.
Previous out of network experience

IND456

About the Company

MPOWERHealth

Integrated spine care networks and neuromonitoring

MPOWERHealth provides integrated solutions for specialty care, focusing on neuromusculoskeletal health. It builds an integrated physician network that enables neuromusculoskeletal physicians to collaborate and improve quality. It offers neuromonitoring services for physicians, hospitals, health systems, and medical facilities. It also creates bundled payor solutions that give direct access to high-quality conservative spine care at a fixed total cost. The company serves over 400 physicians, more than 55,000 patients, and more than 300 facilities across 24 states from its base in Addison, Texas. Goal: help healthcare organizations achieve better outcomes and cost efficiency by coordinating specialized care, standardizing conservative spine treatment, and expanding access through fixed-price bundles.

Company size: 201-500
Company stage: Not listed
Total funding: Not listed
Headquarters: Addison, TX
Founded: 2008

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