Adjustment and Resolutions Specialist

About us

CNSI is a small business in TECHNOLOGY_INFORMATION in Tallahassee, FL. We are professional, agile and our goal is to CNSI is empowering the delivery of public sector healthcare in claims and encounter processing platforms, provider support solutions, and promoting consumer engagement and interoperability. Our technology-enabled products and solutions connect consumers, payers, and providers to improve health outcomes for one in five Americans..

Our work environment includes:

• Modern office setting
• Food provided

The Adjustment & Resolutions Representative will assist with bill-specific research to resolve outstanding issues and provide guidance in a variety of duties. In addition, will assist with the management of departmental inventory, identifying trends, and work assignments for staff. This position is based in Tallahassee, FL.

To learn more about us, check us out at www.cns-inc.com

Press Release: https://bit.ly/3vEZSvg

Job Responsibilities:

• Assist with bill-specific research to resolve outstanding issues and provide guidance in a variety of duties
• Assist with the management of departmental inventory, identifying trends, and work assignments for staff
• Distribute daily work assignments to staff based on inventory volumes and skillsets
• Manage and update a daily inventory spreadsheet for management review
• Research and resolve medical bill data, making necessary corrections of information by comparing data with source documents to identify root causes
• Request additional information needed to complete adjudication of bills
• Research and review submitted bills requesting adjustment consideration, and process according to Government policies and procedures
• Make the appropriate bill adjustment into the claims system according to contractual requirements and timelines
• Code medical bills for medical and travel reimbursement
• Possess unwavering commitment to customer service and operational excellence

Experience/Preferred Skills Required:

• High school diploma or GED with at least five (5) years’ experience conducting research to resolve issues within the healthcare field
• Expert knowledge of medical terminology including medical diagnosis and procedure codes
• General knowledge of Workers Compensation and medical terminology
• Familiar with medical bill/claim forms, ICD-9/10CM coding, CPT coding, bill forms, and other medical coding schemes (certification desired)
• Ability to simultaneously maneuver through various computer claims and eligibility platforms
• Outstanding customer satisfaction skills
• Coding certification and/or extensive coding experience
• Understanding of budget concepts, cost control, management controls, fiscal procedures and financial stewardship
• Full understanding of payroll practices and procedures
• Proven experience with gathering and analyzing data
• Highly proficient in Excel creating spreadsheets, pivot tables, charts, and graphs

CNSI is an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, marital status, genetic status, family responsibilities, protected veteran status, or any other status protected by applicable federal, state, or local law. We are proud of our diversity and encourage all qualified applicants to apply.

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Experience level:

• 5 years

Shift:

• Day shift

Weekly day range:

• Monday to Friday

Work setting:

• Call center
• In-person

Ability to commute/relocate:

• Tallahassee, FL: Reliably commute or planning to relocate before starting work (Required)

Work Location: In person