TeamHealth has ranked three years running as “The World’s Most Admired Companies” by Fortune Magazine and one of America’s 100 Most Trustworthy Companies by Forbes Magazine in past years. TeamHealth, an established healthcare organization is physician-led and patient-focused. We continue to grow across the U.S. from our Clinicians to our Corporate Employees and we want you to join us.
Benefits of working at TeamHealth:
- Career Growth Opportunities
- 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
- Training Programs
- Wellness programs
- Flexible work schedule
THIS IS A HYBRID POSITION
JOB DESCRIPTION OVERVIEW
The Allowables Manager is responsible for managing processes to ensure appropriate action is taken to identify, report, resolve, and prevent, whenever possible, under and over allowed claims.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Interfaces with Patient Accounts Manager regarding under and over allowed claims and payer trends.
- Interface with managed care departments to confirm accuracy of contracts and contract rates in pricing module.
- Review and monitor all daily, weekly, and monthly allowable reports.
- Communicate and coordinate action plan for resolution with payer to include report submissions, appeals, and prevention methods.
- Insure that any settlements/additional payments received from payers are presented to Patient Accounts with clear direction and documentation for posting.
- Participate in monthly calls with HCFS Director of Operations, HCFS Director of Credit Balances, and Billing Center Asst. VP and VP to discuss trends, standardized process, and high-level resolution methods.
- Monitor progress of Allowables Representative to ensure resolution to under and over allowed claims is realized, especially on high-volume payers.
- Attends monthly Billing Center/affiliate A/R conference calls and reports on status of under and allowed claims.
- Other duties as assigned by Asst. VP of Billing Center
- Communicate with BC Management on the progress of projects and assignments