Sr Allowable Representative

TeamHealth is named among the Top 150 Places to Work in Healthcare by Becker's Hospital Review. Newsweek Magazine recognizes TeamHealth as ‘one of the greatest workplaces for diversity, 2024’ and TeamHealth is also ranked as ‘The World’s Most Admired Companies’ by Fortune Magazine. TeamHealth, an established healthcare organization is physician-led and patient focused. We continue to grow across the U.S. from our Clinicians to Corporate Employees. Join us.

What we Offer:

• Career Growth Opportunities
• Benefit Eligibility (Medical/Dental/Vision/Life) the first of the month following 30 days of employment
• 401K (Discretionary matching funds available)
• Generous PTO
• 8 Paid Holidays
• Equipment Provided for Remote Roles

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

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.

Job Requirements: