Reconsideration Specialist - CBO - Full Time

Job Id
130470
Job Location
Addison, TX
Employment Type
Full Time Regular
Industry
Health Care
Concentra
20200622T210911Z
Overview

Under general supervision performs a variety of moderately complex to complex tasks to effectively process various billing adjustments and reconsideration payments according to Concentra and Central Billing Office policies and procedures.

Responsibilities
  • Monitors and communicates improper payments from payors
  • Communicates to management regarding incorrect reimbursement issues
  • Applies appropriate adjustments per contracts or state requirements
  • Processes all reconsiderations with the appropriate state reports, transcription, and explanation of benefits (EOB’s)
  • Follows-up on all previously sent reconsiderations for proper payment
  • Monitors process of short/zero payments for reconsiderations
  • Verifies proper adjustments were processed
  • Communicates with payor community regarding reimbursement issues
  • Other duties as assigned. Duties, responsibilities and activities may change at any time with or without notice
Qualifications

QUALIFICATIONS

  • High school diploma or GED equivalent
  • Customarily has at least two or more years of demonstrated experience in medical billing or collections
  • Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
  • The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies 
  • Familiarity with Microsoft Excel, Outlook, Word experience required
  • Working knowledge of medical CPT/ICD-9 coding
  • Ability to meet with payors and present concerns regarding reimbursement issues
  • Clear understanding of worker’s compensation reimbursement guidelines and regulations
  • Ability to communicate effectively and professionally
  • Excellent time management, writing and documentation skills
  • Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
  • Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
  • Ability to work independently and in a fast-paced environment
  • Ability to handle multiple tasks, projects, duties, and priorities, when assigned
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, including disability/veterans 



We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, sexual orientation, gender identity, disability or medical or veteran status in accordance with federal law. In addition, Concentra Inc. complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains facilities.

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