Medical Rebilling Specialist

Job Id
163293
Job Location
Cranston, RI
Employment Type
Full Time Regular
Industry
Health Care
Concentra
20210617T072957Z
Overview

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.

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Responsibilities

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
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Qualifications

EDUCATION/CREDENTIALS:

  • High School education or equivalent



JOB-RELATED EXPERIENCE:

  • 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.



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Benefits
• 401(k) with Employer Match
• Medical/Vision/Prescription/Dental Plans
• Life Insurance/Disability
• Paid Time Off/Holidays
• Colleague Referral Bonus Program  
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.
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