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Allergy Partners PLLC संयुक्त राज्य अमेरिका में विशेषज्ञ एलर्जी और अस्थमा देखभाल पर केंद्रित एक स्वास्थ्य सेवा संगठन है। इसके एलर्जिस्ट और इम्यूनोलॉजिस्ट का नेटवर्क अस्थमा, खाद्य एलर्जी, ईओसिनोफिलिक एसोफैजाइटिस, साइनसाइटिस, पित्ती और एनाफिलैक्सिस जैसी स्थितियों का निदान और उपचार करता है। देखभाल में एलर्जी और फुफ्फुसीय परीक्षण, एलर्जी शॉट्स, बायोलॉजिक उपचार, खाद्य और पर्यावरणीय इम्यूनोथेरेपी, फार्मेसी सेवाएँ, रोगी-पोर्टल सहायता और नैदानिक अनुसंधान शामिल हो सकते हैं। यह संगठन राष्ट्रीय नेटवर्क के संसाधनों के साथ स्थानीय स्तर पर प्रदान किए जाने वाले उपचार को जोड़ता है और लगभग 150 एलर्जिस्ट और इम्यूनोलॉजिस्ट की टीम की जानकारी देता है।
Remote Billing Integrity Specialist – Allergen Immunotherapy
Supports accurate, compliant charge entry and billing for allergen immunotherapy in a remote role with Allergy Partners. Researches payer requirements, reviews medical records, resolves denials, and advises practice teams on billing policies.
विवरण
- Enter and review allergen immunotherapy charges for accuracy and compliance with federal and payer coding and billing rules.
- Apply AP protocols and payer policies when entering CPT codes and processing bills.
- Research payer manuals, guidelines, and billing rules, and report updates to the Supervisor.
- Complete assigned responsibilities within established timelines and performance standards.
- Follow applicable federal, state, and payer requirements.
- Recommend billing process and policy improvements to the team lead.
- Communicate with practice managers and staff about billing policies, procedures, and regulations.
- Review medical records to determine whether refill, restart, reformulation, and new orders are appropriate.
- Investigate and respond to internal questions about charge entry, billable services, and denials.
- Coordinate across departments to enter charges into the practice management system according to protocols and payer guidelines.
- Maintain detailed knowledge of payer clinical guidelines and reimbursement policies.
- Support accounts receivable representatives with insurance denials by reviewing records, explaining billing issues, and helping coordinate resolutions.
- Assist with billing questions and medical record reviews during pre-billing review.
- Contribute to special billing integrity projects as assigned.
- Complete required training and follow the Code of Conduct, Compliance Program, and department policies.
- Handle other job-related responsibilities as assigned.
- This role has no supervisory responsibilities.
आवश्यकताएँ
- High school diploma or GED equivalent.
- AHIMA or AAPC coding certification preferred.
- Two years of physician-office charge-entry or billing experience involving complex rules.
- Two years of experience in physician-office operations.
- Strong oral and written communication skills.
- Proficiency with Microsoft Excel, Microsoft Word, and electronic health records.
- Four years of physician charge-entry experience involving complex rules preferred.
- Two years of experience billing for multiple physicians and locations preferred.
- Experience with practice management software and electronic medical records preferred.
- Knowledge of medical terminology preferred.
- Experience with allergy-specialty physician billing preferred.
- Knowledge of coding and billing complexities for specialty physician-office charge entry.
- Ability to exercise independent judgment and handle confidential information.
- Understanding of HIPAA and the ability to protect protected health information confidentiality and privacy.
- Ability to analyze information and solve problems.
- Strong communication and interpersonal skills.
- Knowledge of regulatory and policy matters related to coding and billing.
- Awareness of current and emerging medical billing issues, trends, and payer requirements.
- Ability to clearly explain billing requirements to providers, practice managers, and staff.
- Understanding of and experience with electronic health records and physician practice management and billing applications.
- Excellent organization skills and the ability to manage multiple tasks within set deadlines.
- Ability to communicate and collaborate effectively across departments.
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