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Sr Allowables Representative (Remote) - 5447

TeamHealth Dallas, TX (Remote) Full-Time

Join a team of dynamic, results oriented professionals!

Named among “The World’s Most Admired Companies" by Fortune Magazine
Named among "America's 100 Most Trustworthy Companies" by Forbes magazine
Named among “Great Places to Work" by Becker’s Hospital Review

  • Career Growth Opportunities
  • Convenience market on site
  • Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
  • 401K program (Discretionary matching funds available)
  • Employee Assistance Program
  • Referral Program
  • Dental plans & Vision plans
  • GENEROUS Personal time off
  • Eight Paid Holidays per year
  • Quarterly incentive plans
  • Business casual dress code
  • Employee of the month awards with monetary gift and parking space
  • Training Programs
  • Fitness Center with personal trainer on site
  • Wellness programs
  • Flexible work schedule

This is a Remote position!

JOB DESCRIPTION OVERVIEW:

The position is responsible for analyzing and resolving allowable issues, both under-allowed and over-allowed, for TeamHealth-owned and outsourced business sites. Since we envision increasing responsibilities for the person who assumes this role, there are opportunities for career growth and promotion for the right candidate.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Analyzes and works weekly variance reports
  • Approves over-allowed reports to be sent to Overprovisions
  • Reviews and responds to contract management internal fee schedule updates (IFSC) and individual consideration (IC) reports
  • Contacts carriers and submits variance spreadsheets regarding under-allowed (UA) and over-allowed (OA) variances
  • Works with other departments to resolve invoices (Overprovisions, Accounts Receivable, Coding, Provider Enrollment)
  • Analyzes and works monthly cumulative variance reports
  • Formats/distributes overprovisions (OP) government spreadsheet to Allowables Representatives
  • Assists with completing appropriate information to submit issues for fee discrepancies
  • Researches contracts/loading forms to resolve variance issues
  • Performs additional duties and assignments as requested

Job Requirements:

QUALIFICATIONS / EXPERIENCE:

  • High school diploma or equivalent required.
  • Two years previous medical billing experience preferred
  • Knowledge of healthcare reimbursement guidelines, ICD-10 and CPT-4 coding, and physician billing preferred.
  • Proficient in Microsoft Office.
  • Must possess excellent oral and written communication skills.
  • Must be well organized and possess ability to follow-up on claims.
  • Must be self-motivated.

SUPERVISORY RESPONSIBILITIES:

  • None

PHYSICAL / ENVIRONMENTAL DEMANDS:

This job will be performed in a well-lighted and well-vented environment.
Work is oriented around good visual skills.
Eye fatigue may be encountered as extended amount of time is spent in front of computer.
This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, and fax) and/or the ability to perform repetitive motions and/or meet production standards to comply with the essential functions.
Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.

DISCLAIMER:

Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position.
All employees must be able to work with others beyond giving and receiving instructions.
This includes getting along with co-workers, peers and management without exhibiting behavior extremes.
Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor.
Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification.
It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.

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Job Snapshot

Employee Type

Full-Time

Location

Dallas, TX (Remote)

Job Type

Admin - Clerical, Health Care, Insurance

Experience

Not Specified

Date Posted

11/19/2024

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