Allergy Partners PLLC

General

• Process patient and insurance refunds
• Review credits and research patient accounts for patients and insurance
• Verify payment methods and pull remits to determine true credits
• Adjust small balances and convey monies
• Issue patient refund checks
• Prepare refund checks with detailed reports for management review and signature
• Run financial reports for accounting review
• Prepare and mail checks
• File corresponding backup copies
• Process returned refunds with the accounting department and contact patients to resend refunds
• Maintain patient confidentiality and comply with HIPAA and practice compliance guidelines
• Maintain knowledge of practice management and other computer software related to job functions
• Attend required training and requested meetings
• Perform additional duties assigned by the Director of Central Billing Services, Manager, Team Leader, or Supervisor
• Comply with department policies and report policy violations through designated channels

RCM Refund Specialist

Accounts Receivable

• 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.

RCM AR Specialist

Operations

• Reporting directly to the Director, Regional Operation Management, the Regional Operations Manager (ROM) will be responsible for coordinating and facilitating medical practice operations in accordance with corporate standards and directives.
• Serve as a high-level liaison between clinic physicians, practice managers, corporate management, and various departments.
• Lead the development of strategic plans and a budget that adheres to company performance and provider objectives while cultivating team growth to expand market presence.
• Oversee Practice Managers in assigned markets.
• Responsible for financial and operational success and best practice adherence within assigned markets.
• Implement and oversee compliance with all applicable regulatory directives as well as adherence to corporate policies and procedures.
• Monitor practice performance, including budget, A/R, overhead and productivity to promote practice stability and achievement of corporate benchmarks and best practice model.
• Provide written recommendations and develop action plans as necessary.
• Establish strong physician and practice manager relationships as well as provide coaching and development as required.
• Generate and conduct training modules as assigned.
• Coordinate support for practice through troubleshooting and problem solving.
• Coordinate training and implementation of information systems and technology related issues.
• Demonstrate commitment to high satisfaction ratings from physicians and their staff members, co-workers, payers, vendors, and business partners.