Reconsideration Specialist/ Denials
Addison, TX 
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Posted 8 days ago
Job Description
Reconsideration Specialist/ Denials
Location US-TX-Addison
Job ID 283948 Pos. Category Corporate - Central Billing Office Pos. Type Full Time
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.

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.

Responsibilities


Responsibilities
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

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 GED

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
  • Proficient with Microsoft Excel, Outlook, Word
  • Ability to communicate effectively utilizing customer service and organization skills
  • Excellent time management skills with the ability to work under tight time schedules
  • Excellent writing and documentation skills
  • Strong attention to detail
  • Ability to operate 10-key numeric pad by touch
  • Decision making and problem-solving skills
  • Ability to work independently as well as a team player
  • Ability to handle multiple tasks, projects, duties, and priorities

Additional Data
Employee Benefits
  • 401(k) Retirement Plan with Employer Match
  • Medical, Vision, Prescription, Telehealth, & Dental Plans
  • Life & Disability Insurance
  • Paid Time Off & Extended Illness Days Offered
  • Colleague Referral Bonus Program
  • Tuition Reimbursement
  • Commuter Benefits
  • Dependent Care Spending Account
  • Employee Discounts

This job requires access to confidential and critical information, requiring ongoing discretion and secure information management.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.

Concentra is an Equal Opportunity Employer, including disability/veterans
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EOE, including disability/veterans

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, sexual orientation, gender identity, disability or medical or veteran status in accordance with federal law. In addition, Concentra Inc. complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains facilities.

 

Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
High School or Equivalent
Required Experience
1 to 3 years
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