Under indirect supervision performs a variety of basic tasks to moderately complex tasks to effectively process various billing adjustments and reconsideration payments according to Concentra and Central Billing Office policies and procedures.
MAJOR DUTIES AND RESPONSIBILITIES:
- Communicates improper payments from payors
- Identifies and monitors incorrect reimbursement issues
- Identifies and applies appropriate adjustments per contracts or state requirements
- Processes and monitors all reconsiderations ensuring processing with the appropriate state reports, transcription, and explanation of benefits
- Follows-up on all previously sent reconsiderations for proper payment
- Processes short/zero payments for reconsiderations
- Applies proper adjustments
- Communicates with payors regarding issues and resolutions
- Performs other duties as assigned
- High School education or equivalent
- 1- 3 years experience in medical billing or collections
DEMONSTRATED JOB-RELATED SKILLS/COMPETENCIES:
- Strong computer skills
- Working knowledge of medical CPT/ICD-9 coding
- Strong problem solving skills
- Strong communication skills
- Strong organizational skills
- Ability to work in fast pace environment
- Strong attention to detail
- Ability to research workers compensation and coding rules
- Clear understanding of workers compensation reimbursement guidelines and regulations
- Ability to work independently
- Strong customer service skills
- Ability to assist peers and train new colleagues
WORKING CONDITIONS/PHYSICAL DEMANDS:
- Office Environment
- Sitting for extended periods of time
- Ability to work extended hours for month end close as needed
- Ability to lift light weights of under 15 lbs.
This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.
Concentra is an Equal Opportunity Employer, M/F/Disability/Veteran.