Allowables Representative
Job Description
REQUIREMENTS
- High school diploma or equivalent required
- Minimum three years medical billing experience preferred
- Accounts Receivable or Patient Accounts experience essential
- Knowledge of physician billing policies and procedures beneficial
- Computer literate; Excel and Word experience preferred
- Able to work in a fast-paced environment.
- Good analytical and organizational skills
- Able to work independently
- Must possess excellent oral and written communication skills
- Knowledge of CPT and ICD-9 medical coding guidelines preferred
- Good data entry and 10-key skills required
RESPONSIBILITIES
- Runs specific payer under and over allowed reports for submission to carrier
- Completes necessary appeals
- Follows up on appeals and under and over allowed 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 Manager for unusual circumstances that may include system data issues, payer responses, or Managed Care delinquencies
- Performs other duties as requested
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