Reconsideration Specialist
Overview:
Are you looking for a career that transcends the ordinary? At Concentra, we offer opportunities beyond patient care. As a valued member of our team, you'll be part of our efforts to provide exceptional service to our employer clients and exceptional care to their employees.Our values define our path forward – always working to ensure welcoming, respectful, and skillful care. Join Concentra, and see what makes us different and better.
The Central Billing Office (CBO) Reconsideration Specialist 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.
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 CBO supervisor/manager regarding issues and resolution
- Performs other duties as assigned
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
Qualifications:
Education Level: High School Diploma or GEDMajor: Degree must be from an accredited college or university.
Job-Related Experience- 1- 3 years’ experience in medical billing or collections
- Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
- 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
- The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
- 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-paced 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