Overview:
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.
Compensation and Benefits:
- Competitive salary dependent upon years of experience, education level, certifications, and skillset
- Comprehensive health benefits & wellbeing program with opportunity to earn 100% company paid health insurance and up to $1,500 HSA company contributions.
- Competitive 401(k) with up to 4% company match and immediate vesting
- IOM Technologists are eligible for a quarterly utilization bonus up to $2,000 per quarter
- Monetary travel incentive and travel perks available: earn between $150-250 per case day while traveling for case coverage
- On-call pay
- Advanced case training available
- Tuition reimbursement
- Vacation, sick time & company paid holidays included
Job Summary
The Revenue Recovery Specialist
is responsible monitoring award determinations, researching collections prior to arbitration and post arbitration. Must review posting payment and payments by reviewing insurance allowed amount and patient responsibility. Position requires aggressively follow up on unpaid/partially paid claims/CPTs. The Revenue Recovery Specialist must possess critical thinking skills and understanding the revenue cycle as well as commercial insurance payer payment methods and knowledge of government regulations/insurance guidelines.
Responsibilities:
Essential Job Duties and Responsibilities
- Perform follow up with commercial insurance companies on unpaid insurance accounts identified through aging reports
- Initiates demand letters by reviewing the underpayment based on prior collections, patient responsibility on unpaid or partially paid amounts
- Ability to create professional clear and correct grammatical letters
- Ability exercise mathematical skills to add, subtract, multiple to calculate CPT units, along with problem solving skills
- Responsible for reviewing prior payments and ensuring initial payments were posted correctly
- Assist in reconciling deposit and patient collections
- Attend provider meetings/ workshops when needed
- Retrieve additional EOBs to ensure all payment received are posted and fulfill the total amount due after the arbitration process is complete
- Research and identify if a payer is not following propriate laws/guidelines
- Communicate with payment posting Director or team members to identify and resolve issues
- Answer/respond to correspondence related to award determination. Maintains continuity of work operations by documenting and communicating actions, irregularities, and continuing needs
- Communicate daily with internal and external customers via phone calls and written communications
- Identify trends, and carrier issues relating to reimbursements
- Follows HIPAA policies and procedures to ensure protected health information is secure.
- Other duties as assigned
Qualifications:
Education and/or Experience
- High School degree or equivalent
- 2-5 years medical collection experience
- 1 year of Department of Insurance complaints experience, preferred
- Experience with MS Office applications including Word, Excel, Access, & Outlook
Skills/Specialized Knowledge
- Basic medical terminology knowledge
- Detail oriented and strong organizational and communication skills
- Knowledge and ability for data entry and retrieval using a standard keyboard
- Superior customer service skills
- Manage multiple projects and timelines
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
Remote work environment, ability to work independently and in a group environment
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