Reconsideration Specialist

Concentra, Inc; Addison (TX); On-site; USD 40,000 - 55,000; Full time

Benefits offered by this job

401(k) Retirement Plan with Employer Match

Medical, Vision, Prescription, Telehealth, & Dental Plans

Life & Disability Insurance

Paid Time Off & Extended Illness Days Offered

Tuition Reimbursement

Commuter Benefits

Dependent Care Spending Account

Employee Discounts

Job summary

Concentra, Inc is looking for a Reconsideration Specialist based in Addison, Texas. This full-time role involves processing billing adjustments and reconsideration payments while ensuring compliance with company policies.

The ideal candidate has a high school diploma and 1-3 years of experience in medical billing. Responsibilities include communicating payment issues and applying necessary billing adjustments. The position requires attention to detail and strong problem-solving skills.

Qualifications

• 1-3 years' experience in medical billing or collections.
• Ability to handle sensitive and confidential information.

Responsibilities

• Communicates improper payments from payors.
• Processes and monitors all reconsiderations for proper payment.
• Applies appropriate adjustments per contracts or state requirements.

Skills

Service Mentality

Attention to Detail

Sense of Urgency

Initiative

Flexibility

Customer Service Skills

HIPAA Compliance

Communication Skills

Organizational Skills

Problem-Solving Skills

Strong Computer Skills

Education

High School Diploma or GED

Job description

Reconsideration Specialist

Location: US-TX-Addison

Job ID: 346606 | Pos. Category: Corporate - Central Billing Office | Pos. Type: Full Time | Recruiter: Cecilia Dunn

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.

• Employment Type: Full-time
• Schedule: 1st shift / standard business hours (Monday-Friday)
• Work Environment: 100% onsite (in-office)
• Location: Midway Road Addison, Texas

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 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.

Qualifications

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

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

Concentra is an equal opportunity employer that prohibits discrimination, and will make decisions regarding employment opportunities, including hiring, promotion and advancement, without regard to the following characteristics: race, color, national origin, religious beliefs, sex (including pregnancy), age, disability, sexual orientation, gender identity, citizenship status, military status, marital status, genetic information, or any other basis protected by federal, state or local fair employment practice laws.