Reconsideration Specialist II - CBO

Company:Concentra Location:Addison, TX 75001 Job Category:Medical/Health Reference Code:conc-00018614 Serving the occupational, auto and group healthcare markets, Concentra provides employers, insurers and payors with a series of integrated services that include employment-related injury and occupational healthcare, in-network and out-of-network medical claims review and repricing, access to preferred provider organizations, first notice of loss services, case management and other cost containment services. Concentra provides its services to approximately 136,000 employer locations and 3,700 insurance companies, group health plans, third-party administrators and other healthcare payors. The Company has over 300 medical centers located in 40 states. It also operates the Beech Street and FOCUS networks which include 544,000 providers, 52,000 ancillary providers and 4,400 acute-care hospitals nationwide. Concentra is an Equal Opportunity Employer.NOTICE:Employment Verification Done. Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. JOB SUMMARY: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.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 EDUCATION/CREDENTIALS:'High School education or equivalentJOB RELEVANT EXPERIENCE:'1 ' 3 years experience in medical billing or collectionsDEMONSTRATED 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 colleaguesWORKING CONDITIONS/PHYSICAL DEMANDS: 'Office environment To Apply, Click here The Circle of Success.Concentra's mission is to improve the quality of life by making health care accessible and affordable. We serve the occupational, urgent care, and automobile markets with a wide range of services: Employment-related injury care and occupational health care provided at more than 320 Concentra-managed medical centers in 40 states. Urgent care services provided to the public at selected medical center locations in key metropolitan areas. Specialty occupational health care solutions provided to employers through on-site locations, by traveling to the workplace, or via the Internet and telephone. Automobile claim services through our Auto Injury Solutions division. The Circle of Opportunity. Concentra manages more than 320 medical centers in 40 states and continues to expand our geographic reach through the acquisition of established medical providers and the development of new locations. We are actively expanding our Urgent Care service offering by adding this capability to existing Concentra Medical Center locations. Our specialty health services, which we refer to as our Health Solutions division, is rapidly expanding as we identify new ways to provide customized health care solutions for employers and their workers.The Circle of Teamwork. Concentra brings together talented, compassionate people to solve the highly complex issues of health care delivery, accessibility, and affordability. Every day, we make a difference in the lives of thousands of people through our ability to improve health care efficiency and outcomes. Your career path and development can be on-the-go at Concentra, where you can advance as far as your ideas and performance can take you.