Regional Coding & Compliance Specialist

Company:Concentra Location:Addison, TX 75001 Job Category:Medical/Health Reference Code:conc-00018316 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: Responsible for overall coding and compliance review within Concentra Health Services to optimize revenue, appropriate services and expense control. Major Duties and Responsibilities:' Identifying missed charges and thus missed revenue providers missed and advising and directing on services to order based on patient's injuries and optimize revenue and expenses.' Audit coding practices in our urgent care clinics for accuracy and completeness for optimal reimbursement within the rules of the workers'compensation fee schedules. ' Provide coding support for the Central Business Office. ' Implement and monitor changes necessary to improve coding processes.' Monitor State Workers' Compensation changes to ensure the most current information is available. ' Organize and schedule monthly training as indicated from audit results, denial and down coding trends and as requested by medical directors and operational management to providers and clinical staff. ' Other duties as assigned such as coding newsletters, assisting in IST initiatives, or supervising market level coding specialist.Interaction:Internal: CBO and Administrative Personnel, CBO Directors and Managers, Medical Director, Medical Staff, Operations Director, CAs, Clinic StaffExternal: Payers, representatives of the governing or ruling entity for state Workers compensation regulationsWorking Conditions: Office environment, 20% - 50% travel Qualifications:Five years progressive healthcare billing, coding and managerial experience plus CPC or CCS-P Coding certification Auditing skills for coding quality and complianceBasic computer skills ' PowerPoint, Excel, WordStrong process management skillsFamiliarity with state specific workers compensation regulationsTraining and presentation experience 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.