Director Denials Management Jobs in Riverside, RI

Are you ready to take your career to new heights? At Concentra, you will be a vital member of our patient care team and play a crucial role in providing exceptional care to our patients. Our mission is to improve the health of America's workforce, one patient at a time. Join us at Concentra and see how your clinical competency and compassion can make a meaningful difference in the lives of the patients you serve.

The Physical Therapy Support Specialist (PTSS) works to support the Center Therapy Director (CTD) and Staff Therapists, allowing them to focus on providing excellent patient care. The PTSS is responsible for therapy referral management, patient scheduling, assisting with patient registration and check-out, supply ordering, maintaining cleanliness of the therapy department, and may assist with some medical back office duties as assigned. This position ensures that every patient is treated with quality clinical care and is provided a welcoming and respectful experience.

• Obtain timely authorizations from clients and/or insurance carriers for therapy treatments as prescribed by clinicians
• Utilize the electronic referral module to maintain records for all active referrals of responsibility including detailing referral status, client/insurance/patient correspondence, etc.
• Responsible for processing referrals utilizing company tools and resources to ensure that referrals are processed appropriately based on state guidelines or client specific direction.
• Work with medical and therapy leadership to ensure our medical model is followed as it relates to therapy referrals.
• Report any denials or delays to leadership as needed
• Must ensure all authorized visits are scheduled according to the clinician's referral without going above the number of authorized visits or outside of authorized date range
• Contact patients who miss an appointment and/or report missed appointment to employer
• Document any cancelled or rescheduled appointments in the patient's EMR and partner with Center Operations Director (COD)/CTD to evaluate any cases that may be eligible for closure as an inactive case
• Responsible for clerical tasks in both the front and back office associated with patient care and proper record keeping. Ensure accuracy in documentation.
• Cross train to perform Front Office duties including greeting patients, obtaining authorization, check in/out, communicating wait times, answering multi-line telephone system, distributing employer results/paperwork, etc.
• Responsible for daily therapy supply inventory management, wiping down treatment tables and equipment, washing/folding therapy linens, documenting equipment daily logs, performing Human Performance Evaluations (HPE's), and rooming patients for recheck appointments
• Maintains therapy equipment including but not limited to hydrocollator, freezer, and paraffin and completes corresponding maintenance logs as applicable (daily/weekly/monthly/etc.)
• In partnership with center leadership, assist with patient flow and volume
• Keep patients informed of expected wait times during all aspects of the center visit
• Assist in maintaining a neat, clean, and orderly appearance throughout the facility.
• Facilitate maintenance and required service on all therapy equipment.
• Follow HIPPA guidelines and safety rules
• Complete reports/logs as assigned by center leadership
• Attend center staff meetings or huddles as required
• Participate in initial and ongoing training as required
• May also perform various back office tasks including but not limited to urine drug screens and breath alcohol tests

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.

Education Level: High School Diploma or GED

Job-Related Experience

• Customarily has at least six months or more of referral management experience
• Previous medical office experience preferred
• Working knowledge of state-specific occupational medicine requirements preferred

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
• 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
• Demonstrated effective communication and interaction with employers, patients, providers, and other colleagues
• Demonstrated ability to maintain working relationship with all levels of colleagues
• Demonstrated intermediate knowledge of Microsoft Office such as Word, Excel, Outlook, and entry of data into various systems/applications
• Strong teamwork with peers and center leadership team

• 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 position is eligible to earn a base compensation rate in the state range of $18.18 to $23.63 hourly depending on job-related factors as permitted by applicable law, such as level of experience, geographic location where the work is performed, and/or seniority.  Accepting applications on an ongoing basis.

• External candidates: submit your application on concentra.com/careers
• Current colleagues: visit the internal career portal on the main page of MyConcentra to apply
• Center Achievement Bonuses

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 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.