Job Description

TeamHealth has ranked three years running as “The World’s Most Admired Companies” by Fortune Magazine and one of America’s 100 Most Trustworthy Companies by Forbes Magazine in past years. TeamHealth, an established healthcare organization is physician-led and patient-focused. We continue to grow across the U.S. from our Clinicians to our Corporate Employees and we want you to join us.

This is a Remote position!

JOB DESCRIPTION OVERVIEW:

The Allowables Representative is responsible for providing support to the Allowables Analyst to resolve underallowed claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Runs specific payer underallowed reports for submission to carrier;
• Reviews payer overallowed reports to verify if the claims are truly over paid or over contractualized;
• May need to work with the Refund Department to verify the validity of an insurance refund request;
• Completes necessary appeals;
• Follows up on appeals and underallowed reports with carrier;
• Runs queries to monitor progress;
• Completes research form for submission to Managed Care department;
• Follows up with Managed Care on any delinquent requests;
• Consults with Allowables Analyst for unusual circumstances that may include system data issues, payer responses, Managed Care delinquencies;
• Other duties as directed by management.