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Allowables Representative in kn at TeamHealth

Date Posted: 9/20/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    kn
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    9/20/2018

Job Description

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
  • Free Parking
  • Free coffee daily
  • Employee of the month awards with monetary gift and parking space
  • Training Programs
  • Fitness Center with personal trainer on site
  • Awesome Facility with terrific amenities
  • Wellness programs
  • Flexible work schedule

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.

Job Requirements

QUALIFICATIONS / EXPERIENCE:

  • Minimum High School diploma or equivalent;
  • Additional training in medical billing preferred;
  • Accounts Receivable experience preferred;
  • Knowledge of physician billing policies and procedures helpful;
  • Ability to understand and interpret ambiguous contract language;
  • Computer literate;
  • Able to work in a fast-paced environment;
  • Good analytical skills;
  • Good organizational skills;
  • Able to work independently;
  • Excellent oral and written communication skills;
  • Knowledge of CPT and ICD-10 medical coding guidelines preferred;
  • Strong data entry and 10-key skills;
  • Training classes and seminar attendance may require travel;
  • Regular and predictable onsite attendance;
  • High level of interaction and teamwork.

SUPERVISORY RESPONSIBILITIES:

  • None

PHYSICAL / ENVIRONMENTAL DEMANDS:

  • Job performed in a well-lighted, modern office setting
  • Occasional standing/bending
  • Occasional lifting/carrying (20lbs or less)
  • Some travel locally and overnight
  • Moderate stress
  • Prolonged sitting
  • Prolonged work on a PC/computer
  • Prolonged telephone work

This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, 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.

Overtime may be required and can be mandated by Management.

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.