RCM AR Specialist

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🔥 6 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟢 Junior

💰 Accounts Receivable

🚫👨‍🎓 No degree required

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Allergy Partners PLLC

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🏥 Healthcare

👥 B2C

Healthcare • B2C

Allergy Partners PLLC is the nation’s largest network of allergists and immunologists delivering specialty allergy and asthma care across the United States. The practice provides diagnosis and treatment for a wide range of allergic and immunologic conditions (asthma, food allergies, eosinophilic esophagitis, sinusitis, hives, anaphylaxis, etc. ) and offers services including in-office testing (skin testing, blood testing, pulmonary function testing, Restech), therapies (allergy shots, biologics, food oral and sublingual immunotherapy, environmental SLIT), a patient portal, pharmacy services, and clinical research. The organization emphasizes local providers supported by a national network, personalized treatment plans, and community-based care, and states it comprises roughly 150 allergists and immunologists.

📋 Description

• Follows up on denied claims and no response within a timely manner • Submits appeals related to contract rate variances with a discrepancy in allowed amounts • Submit Medical Records when requested by the payer for claims processing determination • Monitor and review Payer correspondence from the lockbox and faxes • Monitor, review, and respond to Hub (field) communication inquiries within the 48-hour requirement • Calls payers or looks up claims status online to inquire about unpaid insurance claims • Maintains detailed knowledge of practice management and other computer software as it relates to job functions • Responds to written and telephone inquiries from insurance companies • Builds and Maintain relationships with personnel from assigned carriers • Meets with Pod Lead/Supervisor regularly to discuss and solve reimbursement and insurance follow up concerns.

🎯 Requirements

• High school diploma or GED equivalent, required • Previous Medical Billing and Collections experience preferred • Preference for those with a minimum of eighteen months experience • Comfortable using email and interacting with Internet applications • Knowledge of practice management and Microsoft processing software • Proven understanding of Explanation of Benefits forms, claim forms and the insurance billing process • Working knowledge of managed care, commercial insurance, Medicare, and Medicaid reimbursement • Basic knowledge of CPT and ICD-10 coding • Strong written and verbal communication skills.

🏖️ Benefits

• Continuing education courses as requested • Participation in education to remain current with changes in the Healthcare industry • Complies with Allergy Partners and respective hub/department policies