Billing Integrity Specialist – Allergen Immunotherapy

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🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

📊 Billing Specialist

🚫👨‍🎓 No degree required

👻 Ghost score 12%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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

• Enter allergen immunotherapy charges and review them for accuracy and compliance with federal and payer coding and billing regulations • Follow AP protocols and payer policies for accurate CPT code entry and billing • Research payer manuals, guidelines, and billing rules and notify the Supervisor of updates • Perform assigned duties within designated timelines and performance standards • Comply with federal, state, and payer requirements • Recommend process and policy improvements to the team lead • Interact with practice managers and staff regarding billing and payer policies, procedures, and regulations • Review medical record documentation to determine whether refill, restart, reformulation, and new orders are appropriate • Research, analyze, and respond to internal inquiries about charge entry, billable services, and denials • Work interdepartmentally to ensure charges are entered into the practice management system according to protocols and payer guidelines • Maintain in-depth knowledge of payer clinical guidelines and reimbursement policies • Assist accounts receivable billing representatives with insurance denials by reviewing records, educating on billing issues, and facilitating resolution • Assist with billing issues and medical record review during the pre-billing review process • Assist with special billing integrity projects as assigned • Complete assigned training and comply with the Code of Conduct, Compliance Program, and department policies • Perform miscellaneous job-related duties as assigned • No supervisory duties

🎯 Requirements

• High school diploma or GED equivalent • Coding certification from AHIMA or AAPC preferred • Two years of physician office charge entry/billing following complex rules • Two years of experience in physician office operations • Oral and written communication skills • Competence using Microsoft Office Excel and Word, and electronic health records • Four years of physician charge entry following complex rules preferred • Two years of experience billing for multiple physicians and locations preferred • Experience with practice management software and an EMR preferred • Knowledge of medical terminology preferred • Experience in allergy specialty physician billing preferred • Knowledge of billing and coding complexities related to specialty physician office charge entry • Ability to use independent judgment and manage confidential information • Understanding of HIPAA and ability to maintain confidentiality and privacy of PHI • Ability to analyze and solve problems • Strong communication and interpersonal skills • Knowledge of regulatory and policy issues related to coding and billing • Knowledge of current and developing issues and trends in medical billing and payer requirements • Ability to communicate billing requirements clearly to providers, practice managers, and staff • Understanding of and experience with electronic health records and physician practice management and billing applications • Excellent organizational skills and ability to manage multiple tasks within designated timelines • Ability to communicate and work proficiently interdepartmentally