Reimbursement System Specialist
Concentra Inc. - Addison, TX

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JOB SUMMARY:

Prepare routine worker’s compensation & urgent care fee schedule models to measure &/or forecast financial impact
Prepare and analyze monthly accounts receivable management report and help optimize collection performance
Create new reporting mechanisms to effectively monitor collection trends across the organization daily
Assist AVP of reimbursement in developing new reporting templates (days outstanding trends, specialty network trends, work-site trends, urgent care trends)
Update and manage a monthly staffing model for each of Concentra’s Central Business Offices (CBOs)
Position requires routine interaction with reimbursement Department, CBOs, IT, accounting and operations
Cross-training and systems support with reimbursement Department
Perform Central Business Office audits on-site with assistance of Internal Auditor
Gain strong working knowledge of payer contracts, medical coding, reimbursement

Ensures the delivery of exceptional customer service by improving reporting with Concentra’s service offerings and by putting all customers (internal and external) first and displaying:
  • A healing focus
  • A selfless heart
  • A tireless resolve
MAJOR DUTIES AND RESPONSIBILITIES:

Major activities involved in the work performed.
  • Meets with reimbursement Dept, IT, central business offices, accounting and operations to review A/R impact
  • Develops or improves workflows and system edits used by Concentra’s central business offices
  • Participates in and assists with continuing education programs and policy compliance
  • Recommends potential changes to strengthen controls at CBOs while optimizing cash performance
  • Financial forecasts and impact related to A/R management (staffing, collections, days to collect, delinquency, contracts)
  • Revenue size responsible for: $900M (audits and analyzes performance of entire organization)

Concentra's Data Protection Commitment

* Concentra is committed to protect patient data and to ensure privacy of personal and medical information.
* Every Concentra colleague has the responsibility to adhere to data protection principles.
* If a colleague's role includes handling or processing sensitive data, role-specific policies and requirements apply to ensure the protection of patient information.

Required Skills JOB-RELATED SKILLS/COMPETENCIES:
  • Skill – ability to work independently
  • Excellent written and verbal communication skills
  • Some travel (~ 10%)
  • Strong analytical and organizational skills
  • Proficient with Excel and Pivot tables
  • Working knowledge of worker’s compensation, urgent care and clinical procedures/processes.
  • Working knowledge of diagnoses and commercial payers.
  • Working knowledge of medical office administration and procedures.
Required Experience EDUCATION/CREDENTIALS:
  • College degree with concentration on business
JOB-RELATED EXPERIENCE:
  • 0-2 years entry level
  • This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.

Concentra Inc. - 15 months ago - save job
About this company
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Concentra Managed Care, Inc. is the leading provider of healthcare management and cost containment services to the workers' compensation,...