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Job Requirements of Allowables Representative:
KNOWLEDGE, SKILLS, AND ABILITIES:1.
Knowledge of physician billing policies and procedures is helpful.
2.
Computer literate with experience in Word, Excel, and email.
3.
Accounts Receivable experience preferred.
4.
Ability to understand and interpret ambiguous contract language.
5.
Able to work in a fast-paced environment.
6.
Excellent analytical skills.
7.
Excellent organizational skills.
8.
Able to work independently with minimal supervision.
9.
Experience and interaction skills involving communication to insurance carriers.
10.
Excellent oral and written communication skills.
11.
Able to manage multiple tasks, prioritize, and meet scheduled deadlines.
12.
Knowledge of CPT and ICD-10 medical coding guidelines preferred.
13.
Knowledge of interpreting EOB’s and understanding of NPI forms.
14.
Good data entry and 10-key skills required.
15.
High level of interaction and teamwork.
CREDENTIALS AND EXPERIECE:
Education
1.
Minimum High School Diploma or equivalent.
Additional training in Medical Billing preferred.
Experience
1.
2 to 3 years’ medical billing experience in a medical billing or facility setting.
2.
Excel experience required.
Do you meet the requirements for this job?
Allowables Representative
TeamHealth
Louisville, TN (Remote)
Full-Time
TeamHealth is proud to be the leading physician practice in the U.S. providing exceptional patient care, together. TeamHealth has been recognized as one of the “165 Top Places to Work in Healthcare” for 2026 by Beckers Hospital Review. TeamHealth has also been recognized by Newsweek as one of America’s Greatest Workplaces in Health Care for 2025– We continue to grow across the U.S. from our Clinicians to Corporate Employees. Join Us!
JOB SUMMARY:
The Allowable Representative is responsible for providing support to the Allowables Manager to resolve underallowed and overprovision claims.
JOB FUNCTIONS
JOB SUMMARY:
The Allowable Representative is responsible for providing support to the Allowables Manager to resolve underallowed and overprovision claims.
JOB FUNCTIONS
- Assist with reconciling and applying appropriate action on each invoice on the underallowed and overallowed monthly variance reports to determine if a true variance or discrepancy in loading in system.
- Responsible for reviewing and taking appropriate action on each invoice once carrier returns with their comments.
- Responsible for calling and reviewing correspondence for WC insurance carriers or employer groups pertaining to underallowed invoices.
- Responsible for handling calls to private payors pertaining to underallowed and overallowed claims if applicable.
- Responsible for working invoices in the ETM views for Allowables daily.
- Updates and forwards the Allowable Representative work log to the Allowables Manager on a weekly basis.
- Responsible for updating the insurance carrier contact list, patient services log, and the inappropriate on demand variance log.
- Pulls and copies EOB’s as requested by insurance carriers for underallowed resolution.
- Research contracts to ensure paid correctly and/or system is loaded correctly.
- Runs specific payer underallowed reports for submission to carrier.
- Reviews payer overallowed reports to verify if the claims are truly over paid or if internal issues such as fees loaded incorrectly in IDX.
- From time-to-time files appeal to carriers for the underallowed claims to collect additional monies due.
- Submits reconsiderations on carrier website for assistance with variances.
- Works with the Refund Department to verify the validity of an insurance refund request.
- Completes CM Intake form for fee discrepancies for contract management to research and for Senior to submit via ONBASE.
- Obtains fee schedules/fee updates from carriers when applicable.
- Send spreadsheets of underallowed variances to Senior that need submitted to carrier for research/review for reprocessing.
- Completes special reports for upper management meetings.
- Perform all other duties as directed by management.
Job Requirements:
KNOWLEDGE, SKILLS, AND ABILITIES:
1.
Knowledge of physician billing policies and procedures is helpful.
2.
Computer literate with experience in Word, Excel, and email.
3.
Accounts Receivable experience preferred.
4.
Ability to understand and interpret ambiguous contract language.
5.
Able to work in a fast-paced environment.
6.
Excellent analytical skills.
7.
Excellent organizational skills.
8.
Able to work independently with minimal supervision.
9.
Experience and interaction skills involving communication to insurance carriers.
10.
Excellent oral and written communication skills.
11.
Able to manage multiple tasks, prioritize, and meet scheduled deadlines.
12.
Knowledge of CPT and ICD-10 medical coding guidelines preferred.
13.
Knowledge of interpreting EOB’s and understanding of NPI forms.
14.
Good data entry and 10-key skills required.
15.
High level of interaction and teamwork.
CREDENTIALS AND EXPERIECE:
Education
1.
Minimum High School Diploma or equivalent.
Additional training in Medical Billing preferred.
Experience
1.
2 to 3 years’ medical billing experience in a medical billing or facility setting.
2.
Excel experience required.
1.
Knowledge of physician billing policies and procedures is helpful.
2.
Computer literate with experience in Word, Excel, and email.
3.
Accounts Receivable experience preferred.
4.
Ability to understand and interpret ambiguous contract language.
5.
Able to work in a fast-paced environment.
6.
Excellent analytical skills.
7.
Excellent organizational skills.
8.
Able to work independently with minimal supervision.
9.
Experience and interaction skills involving communication to insurance carriers.
10.
Excellent oral and written communication skills.
11.
Able to manage multiple tasks, prioritize, and meet scheduled deadlines.
12.
Knowledge of CPT and ICD-10 medical coding guidelines preferred.
13.
Knowledge of interpreting EOB’s and understanding of NPI forms.
14.
Good data entry and 10-key skills required.
15.
High level of interaction and teamwork.
CREDENTIALS AND EXPERIECE:
Education
1.
Minimum High School Diploma or equivalent.
Additional training in Medical Billing preferred.
Experience
1.
2 to 3 years’ medical billing experience in a medical billing or facility setting.
2.
Excel experience required.
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