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.

• 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.

Education Level: High School Diploma or GED

Major:
Degree must be from an accredited college or university.

Job-Related Experience

• 1- 3 years’ experience in medical billing or collections

Job-Related Skills/Competencies

• 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