Resolution and Adjustment Specialist

<strong>At CNSI, we strive to be the market leader and most trusted partner for innovative and transformative technology-enabled solutions that improve health outcomes and reduce costs. We&rsquo;re passionate about helping our clients improve the health and well-being of individuals and families. We succeed when our clients succeed.</strong>

Tallahassee FL-CNSI Site - Tallahassee, FL, 32317


<strong>CNSI delivers a broad range of health information technology enterprise solutions and customizable products to a diverse base of state and federal agencies. We align, build, and manage innovative, high-quality, cost-effective solutions that help customers achieve their mission, enhance business performance, reduce costs, and improve health for over 51 million Americans.</strong>

keywords: position summary,research,claims,operational excellence,knowledge,education,claims,customer care

Full Time

Overview: <p class="ignore-global-css"><span class="ignore-global-css"><strong class="ignore-global-css">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.</strong></span></p> <p class="ignore-global-css">&nbsp;</p> <p class="ignore-global-css"><span class="ignore-global-css"><strong class="ignore-global-css">**This is a Federal Contract;&nbsp;you will be required to pass&nbsp;a federal&nbsp;background check and fingerprinting before you can start**</strong></span></p> <p class="ignore-global-css">&nbsp;</p> <p class="ignore-global-css"><span class="ignore-global-css">The Adjustment &amp; 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.</span></p> <p class="ignore-global-css">&nbsp;</p> <p class="ignore-global-css"><span class="ignore-global-css"><strong class="ignore-global-css">To learn more about us, check us out at&nbsp;</strong><a href="" target="_blank" rel="noopener noreferrer"><strong class="ignore-global-css"></strong></a></span></p> <p class="ignore-global-css">&nbsp;</p> <p class="ignore-global-css"><span class="ignore-global-css"><strong class="ignore-global-css">Press Release:&nbsp;</strong><a href="" target="_blank" rel="noopener noreferrer"><strong class="ignore-global-css"></strong></a></span></p>
Responsibilities: <ul class="ignore-global-css"> <li class="ignore-global-css"><span class="ignore-global-css">Research and Resolve medical bill data, making necessary corrections of information by comparing data with source documents to identify root causes</span></li> <li class="ignore-global-css"><span class="ignore-global-css">Request additional information needed to complete the adjudication of bills.</span></li> <li class="ignore-global-css"><span class="ignore-global-css">Research and Review submitted bills requesting adjustment consideration, and process according to Government policies and procedures.</span></li> <li class="ignore-global-css"><span class="ignore-global-css">You will make the appropriate bill adjustment into the claims system according to contractual requirements and timelines</span></li> <li class="ignore-global-css"><span class="ignore-global-css">You will possess an unwavering commitment to customer service and operational excellence</span></li> </ul>
Requirements: <ul class="ignore-global-css"> <li class="ignore-global-css"><span class="ignore-global-css">High school diploma or GED with at least five (5) years&rsquo; experience conducting research to resolve issues within the healthcare field</span></li> <li class="ignore-global-css"><span class="ignore-global-css">Expert knowledge of medical terminology including medical diagnosis and procedure codes</span></li> <li class="ignore-global-css"><span class="ignore-global-css">General knowledge of Workers Compensation and medical terminology</span></li> <li class="ignore-global-css"><span class="ignore-global-css">Have a familiarity with medical bill/claim forms, ICD-9/10CM coding, CPT coding, bill forms, and other medical coding schemes (certificate desired).</span></li> <li class="ignore-global-css"><span class="ignore-global-css">Ability to simultaneously maneuver through various computer claims and eligibility platforms</span></li> <li class="ignore-global-css"><span class="ignore-global-css">Outstanding customer satisfaction skills</span></li> </ul> <p class="ignore-global-css"><span class="ignore-global-css">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.</span></p> <p class="ignore-global-css"><span class="ignore-global-css">#LI-SF1</span></p>