Reimbursement System Specialist will prepare routine workers’ compensation, urgent care, group health physical therapy, & primary care fee schedule models to measure &/or forecast financial impact of changes. Colleague will also prepare and analyze monthly accounts receivable management reports to help optimize collection performance. Routine audits of company’s Central Business Offices and payer contracts will be conducted, as well as gaining a strong working knowledge of medical coding and reimbursement trends.
Ensures the delivery of exceptional customer service by improving reporting with Concentra's service offerings and by putting all customers (internal and external) first and displaying:
- A healing focus
- A selfless heart
- A tireless resolve
MAJOR DUTIES AND RESPONSIBILITIES:
- Meets with Coding, Reimbursement Dept, IS, central business offices, accounting and operations to review A/R and revenue cycle impact
- Analysis of payer contracts to ensure compliance with reimbursement expectations
- Develops or improves workflows and system edits used by Concentra’s central business offices to maximize colleague productivity
- Responsible for all of Concentra’s practice management system tables related to providers, center demographics, charge masters, legal names, remittance, formularies and ICD-9 or HCPCS codes
- Participates in and assists with continuing education programs, system training and policy compliance
- Recommends potential changes to strengthen controls at CBOs or within operations while optimizing cash performance
- Manages internal reporting to maximize revenue opportunities while minimizing bad debt
- Financial forecasts and impact related to A/R management (staffing, collections, days to collect, delinquency, contracts)
- Bachelor's Degree
- Skill – ability to work independently
- Excellent written and verbal communication skills
- Some travel (~ 10%)
- Strong analytical and organizational skills
- Proficient with Excel and Pivot tables
- Working knowledge of worker’s compensation, urgent care and clinical procedures/processes.
- Working knowledge of diagnoses and commercial payers.
- Working knowledge of medical office administration and procedures
- 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.