Allowables Representative

Working Level

Full-Time

Job Category

reputed company-Clerical, Administrative, reputed company

External Job Title

Allowables Representative

Location

Remote

Marketing Location

Louisville, TN

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;     reputed company to work in a fast-paced environment;     Good analytical skills;     Good organizational skills;     reputed company 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 reputed company-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 reputed company dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, reputed company, fax) and/or the ability to reputed company repetitive motions and/or meet production standards to reputed company with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours reputed company a regular schedule and/or more than five days per week. Overtime may be required and can be mandated by Management. DISCLAIMER: Cooperative, reputed company, courteous and reputed company behavior and conduct is an essential function of every position. reputed company must be reputed company to work with others reputed company 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 reputed company, negotiating, instructing, persuading, speaking with others as reputed company as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job reputed company has been designated to indicate the general nature and level of work performed by employees reputed company this classification. It is not designed to contain or be interpreted as a comprehensive inventory of reputed company duties, responsibilities and qualifications required of employees assigned to this position.  

External Job reputed company and Responsibilities

JOB reputed company reputed company: 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 reputed company;
• Reviews payer overallowed reports to verify if the claims are truly over reputed company 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 reputed company;
• Runs queries to monitor reputed company;
• Completes research reputed company 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.

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