Suspense Specialist

Company:Concentra Location:Plano, TX 75024 Job Category:Customer Support/Client Care Reference Code:conc-00018637 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: Maintain and administer the Market Suspense Client base-clearing the suspense, development of Protocols and notification of client in accordance with Concentra policies, practices and procedures. MAJOR DUTIES AND RESPONSIBILITIES: 'Receives/manages client info form 'Completes protocol form and submits to the Protocol Specialist. Communicates actively with protocol specialists to ensure accuracy and timely removal from suspense. 'For new clients, verifies all protocol data-and provides a brief overview of our services. Informs new clients that we will have a Health Services Manager visit them within 5 days to review their new protocols and provide them with authorization forms. 'Mails new protocols to the appropriate Center Admistrator/Health Services Manager. 'For UDS additions, completes an NDI blocksheet to set up the client with NDI (and adds the account number to the protocol notes). 'Updates protocols as needed as suspense items are addressed. 'For existing clients, verifies information added and does a quick "thanks for continuing to use Concentra"-advises them that an Account Manager may be contacting them within 5 days to review updated protocols (when appropriate). Mails new protocols appropriate Center Administrator/Account Manager. 'Notifies Center Administrator's of suspense items that were inappropriately suspended (duplicate entries, wrong employer, etc), and removes charges when appropriate. Adjusts charges as needed to match existing protocols. 'Works with National Accounts on changes/additions/deletions and all TPA related issues. 'In addition, involved with: oCross selling opportunities between markets oAssisting in client resolution of minor "miscommunication" issues oMaintaining data base to capture trends and training issues oIdentifies referral sources, calls(or sends a thank you to the referral source (TPA's, Comp Commissions, Other Existing clients, etc) 'Performs other duties as assigned. EDUCATION/CREDENTIALS: 'High school diploma/some college preferredJOB RELATED EXPERIENCE: '2-5 Years in CHS centers-with clear understanding of protocol requirementsDEMONSTRATED JOB-RELATED SKILLS/COMPETENCIES: 'Familiarity with Microsoft Excel and Word 'Excellent communication and organizational skills (including telephone etiquette) 'Problem solving and ability to handle multiple tasks 'Ability to maintain composure with deadlines 'Excellent writing and documentation skills 'Strong Customer Service Skills required. 'Strong Organizational Skills 'Proficiency with Occusource 'Ability to plan and organize duties 'Strong oral communication skillsWORKING CONDITIONS/PHYSICAL DEMANDS: 'Office environment, 'Sitting for extended periods of time 'Heavy data entry, telephone work 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.