Careers

At Margin Recovery International, our people are talented, intellectually curious and driven to make a difference.

We have formal leadership and technical training programs, but new hires also develop their skills working alongside their colleagues and our partners—and are empowered to contribute from their very first client engagement.

We’ve worked hard to hone our understanding of the type of people who thrive in our culture—dynamic, driven individuals on a quest for challenging and rewarding careers. That means we’re choosy about who we bring aboard, but successful candidates feel at home right away.

Our foundation as a superior professional services firm is rooted in our core values: Commitment, Professionalism, Teamwork, Common Sense, Personal Respect, and Communication.

We live these values in everything we do—from client engagements to the work we do with vendors and with fellow employees. If you share them, too, you just may have a future here.

If you’ve been dreaming of working with innovative colleagues who support and inspire you, consider us.

Scroll down to learn more and apply or email our Recruiting Team at HR@marginrecovery.com.

Career Opportunities

Welcome to our career opportunities page. To learn more about jobs we have listed below, please click on the job name. To apply for any of our positions please click the "Apply Now" button below to begin. If you have any questions or difficulty applying please email us at HR@marginrecovery.com.

Utilization Review Clinician

Utilization Review Clinician

Interested in joining a fast-growing company with a great work environment, which delivers exemplary clinical services to our clients. We are in search of an experienced RN who is looking for an exciting opportunity to be a part of a rewarding and diversified company culture. Our clinical services encompass performing prospective, concurrent, and retrospective review for a high-volume client.

This position requires the candidate to have strong communication skills both verbal and written as well as expertise in applying medical necessity criteria. Qualified candidates must be able to demonstrate a proven track record of delivering excellent results on key performance indicators. The candidate must be able to function independently with exceptional time management and organizational skills.

The Utilization Review Clinician will be responsible for creating &/or contributing to Client reporting; provides effective Client communication – calls, e-mails, coordination of care; utilizing InterQual® (or other client criteria set) to apply medical necessity criteria; contacting the payer for authorization and conducting medical necessity reviews; documentation of clinical outcomes for prospective, concurrent and retrospective review in client system; and comply with applicable government regulations as it pertains to Utilization Review and related billing.  

Education / Experience

  • Valid registered nursing license
  • Minimum of 2 years clinical experience in an acute care setting and
  • Minimum of 2 years with 2 plus years of health care revenue cycle experience
  • ACM or CCM accreditation a plus

 

The above statements describe the general nature and level of work being performed as of the date of preparation and approval. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of the position. Employees holding this position will be required to perform any other job-related duties as requested by management. The job description does not constitute an employment agreement between the employer and employee, and all requirements are subject to possible modification to reasonably accommodate individuals with disabilities.

Revenue Cycle Auditor/Analyst

Revenue Cycle Auditor/Analyst

Interested in joining a fast-growing company with EVERY Friday off? As an Auditor on MRI’s Audit & Recovery team, you'll help build a growing organization, win over hospital, health system, and surgery center clients with superior customer service and service offerings. You’ll be a critical part of the growth of an emerging leader in hospital revenue cycle solutions. You will work alongside MRI team members to execute project plans which enhance the bottom-line profits for our clients.

The Auditor will be responsible for activities focused on assessing/analyzing third party payments, including Managed Care, Medicare, and Medicaid, as it relates to hospital insurance reimbursement. This includes recording and analyzing data, filing appropriate appeals based on findings to ensure additional payment is received in a prompt manner.

 Essential Duties and Responsibilities:

  • Leverage data-mining and reimbursement modeling tools to review and identify underpayments/denials which are due for additional reimbursement from the payer
  • Identify and document underpayment root causes by contacting payers via phone and through review of client systems and account documentation
  • Submit written appeals detailing expected reimbursement and clearly outlining reasons for additional payment, including citation of contract language, policies, and industry standard in a persuasive manner
  • Gain knowledge of general hospital policies and procedures, hospital underpayments, and revenue cycle maximization opportunities
  • Ensures productivity and quality standards are met
  • Participate in internal client meetings, contributing to a greater understanding of project and initiative progress
  • Coaches/Partners with other team members
  • Identify and research new placement concept opportunities
  • Assist in client reporting
  • Strict adherence to HIPAA privacy and security rules, including following MRI policy at all times
  • All other duties as assigned

Knowledge, Skills, Abilities:

  • Strong analytical, technical, and creative problem-solving skills
  • Demonstrated ability to analyze, understand, and communicate complex issues and trends.
  • Demonstrated interpersonal skills. Ability to clearly articulate goals and expectations to team members and communicate results to MRI Management.
  • Customer-service orientation with ability to independently interact with a range of personalities and styles to establish effective relationships internally & externally.
  • A positive and optimistic attitude that is maintained despite tight deadlines and competing priorities.
  • Genuine enthusiasm for working for an evolving start-up with the ability to embrace new ideas.
  • Ability to consistently demonstrate high personal ethics, integrity, prudence, energy, initiative, and self-confidence.

Education/Experience:

  • Bachelor’s degree with Healthcare, Business, or relevant background preferred
  • Relevant professional experience within Hospital/Insurance industry preferred
  • Expertise within the MS Office Suite including Excel, Word, Outlook, and Access preferred

COMPENSATION AND BENEFITS

  • Four (4) day work weeks
  • Competitive salary commensurate on relevant experience
  • Paid time off and holidays
  • Health insurance package (partially paid by employer)
  • 401(k) plan with employer match after one year of service

Work a minimum of 40 hours per week.

CLICK HERE TO APPLY NOW

Clinical Review Clinician

Clinical Review Clinician 

This individual will be responsible for one or more types of medical record medical necessity clinical reviews.  Clinical reviews may be (1) inpatient or outpatient, (2) for any payer type and (3) may be concurrent, pre-bill or retrospective based on the client service provided.  Examples work activities include and are not limited to:  Clinical Pre-certifications, Utilization Reviews, Clinical Appeals, and Patient Status Reviews.  This role requires strong communication skills both verbal and written as well as expertise in applying medical necessity criteria, doing research on current clinical practices and rules/regulations, and data analyses for the purpose of identifying for the client areas of performance improvement opportunity.  The Clinical Review Clinician will be working directly with clients; managing their accounts and relationships effectively.   

Essential Duties and Responsibilities:

Include the following: 

  • Reviews all available encounter documentation, including but not limited to, medical record and payer correspondence  
  • Utilizes InterQual® (or other client criteria set) to apply medical necessity criteria and determine appropriate patient status and level of care medical necessity  
  • Utilizes applicable payer guidelines to obtain patient pre certification/ authorization and understand covered benefits; For government payers utilizes local and national coverage determinations (LCD, NCD) and other as applicable 
  • Authors factual appeal letter based on available documentation and/or pertinent research articles to support clinical appeal 
  • Documents clinical rationale for pre-certification, status determination, or appeal outcome in client system 
  • Complies with applicable government regulations as pertains to Utilization Review and related billing   
  • Keeps MRI leader(s) informed of outcomes; progress, opportunities, and trends
  • Meets or exceeds deadlines 
  • Creates &/or contributes to Client reporting 
  • Provides effective client communication – calls, e-mails 
  • All other duties as assigned 

Knowledge, Skills, Abilities:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

  • Expertise with medical necessity criteria set(s) 
  • Knowledge/ ability to conduct through on-line research of accepted standards of practice, provider manuals, regulations, etc. 
  • Understanding of hospital billing and reimbursement; basic patient accounting principles including but not limited to: adjustments, credits, debits, patient liability and revenue codes 
  • Ability to gain knowledge of client’s general hospital policies and procedures, departments, and revenue cycle technology 
  • Establishes strong working relationships between financial and clinical department leaders  
  • Communicating with partners such as physician offices to secure necessary documentation to support pre-certification or appeal 
  • Customer service orientated and understanding of key drivers of client satisfaction; ability to bring improvements to the overall customer experience 
  • Demonstrates professionalism in all interactions with internal and external clients, including written, client-facing, and over the phone 
  • Strategic thinking skills 
  • Knowledge of Microsoft Office tools including Excel, Outlook, SharePoint, PowerPoint and Word 
  • Basic proficiency in computer skills including but not limited to typing, spell check  and use of standard office equipment such as copier, fax 
  • Prioritize and manage multiple tasks/assignments and meet established time frames 
  • Strong presentation and communication skills  
  • Must have strong verbal and written communication skills 
  • Ability to interact with numerous client hospital departments to obtain appropriate info needed to appeal/resolve claims 
  • Ability to interact with payer representatives to bring account to resolution 
  • Ability to communicate to a wide range of audiences from senior executives to front-line employees 
  • Ability to work independently and as a team member 
  • Ability to work with little to no supervision in either office setting or in a remote setting 
  • Maintains professional license through continuing education  

Education / Experience

Include minimum education, technical training, and/or experience required to perform the job. 

  • Valid nursing license 
  • Minimum of 1 year clinical experience in an acute care setting and  
  • Minimum of 1 year with 2 - 5 years preferred of health care revenue experience cycle (e.g. Clinical Pre-cert, Utilization Review, Clinical Appeals) 
  • Previous hospital and/or insurance utilization/ case management experience preferred 
  • Strong fundamental knowledge of third party practices, including Managed Care, Medicare, Medicaid preferred 
  • Understanding of Government audits related to medical necessity preferred 
  • Understanding of explanations of benefits (EOB), Managed Care contracts, Contract language and Federal and State guidelines preferred 
  • Experience with various health care patient accounting and reconciliation systems and electronic medical record systems preferred 
  • Understanding of ICD-9 and ICD 10, CPT/HCPCS coding and medical terminology  though Coding or Clinical Documentation Specialist experience preferred 
  • Previous utilization of medical necessity criteria sets (InterQual®, MCG, NCD’s, LCD’s) preferred 
  • Intermediate skills in setting up, maintaining and working with Excel spreadsheets and graphs and PowerPoint reports preferred  

The above statements describe the general nature and level of work being performed as of the date of preparation and approval. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of the position. Employees holding this position will be required to perform any other job-related duties as requested by management. The job description does not constitute an employment agreement between the employer and employee, and all requirements are subject to possible modification to reasonably accommodate individuals with disabilities. 

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

  • Must be able to work in sitting positionuse computer and answer telephone for long periods of time 
  • Ability to lift and/or move up to 25 pounds 
  • Specific vision abilities required by this job include close vision. 
  • Ability to travel as needed 
Clinical Support Associate

As a Support Associate on MRI’s Clinical team, you'll help build a growing organization, win over hospital, health system, and surgery center clients with superior customer service and service offerings. You’ll be a critical part of the growth of an emerging leader in hospital revenue cycle solutions. You will work alongside MRI team members to execute project plans which enhance the bottom-line profits for our clients.
The Support Associate will work with our Clinical team and will be responsible for supporting health care revenue cycle operations. This includes clerical support, data entry and basic analysis, follow-up activities and other duties as assigned.
ESSENTIAL DUTIES AND RESPONSIBILITIES
• Assist assigned department staff and management in day-to-day operations
• Meets productivity and quality standards
• Prepares documents including but not limited to client reporting documents
• Performs data entry
• Performs follow-up on specific accounts as required by business unit or client and documents such in designated system
• Performs various clerical duties, including but not limited to sorting, filing, scanning, and indexing documents
• Answers phones and records/transfers/relays messages as needed
• Keeps Manager informed various departmental issues
• Partners with other team members as needed
• Other duties as assigned
EDUCATION / EXPERIENCE / REQUIREMENTS
• 2 years of clerical support; health care revenue cycle experience preferred; commensurate experience may be considered
• High School Diploma or GED required

We are an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex (including gender, pregnancy, caregiver status, sexual orientation or transgender status), national origin, citizenship, age, disability, marital status, genetic information or history or any other legally protected class.