Reconsideration Specialist

Employment Type

: Full-Time


: Miscellaneous

OverviewUnder 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.ResponsibilitiesMAJOR 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 assignedQualificationsEDUCATION/CREDENTIALS:* High School education or equivalentJOB-RELATED 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* Sitting for extended periods of time* Ability to work extended hours for month end close as needed* Ability to lift light weights of under 15 lbs.

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