Job Type
Full-time
Description
Managing the revenue cycle specifically for allergy and immunology services:
- Specialty Coding: Code and bill specific services using ICD - 10, CPT and HCPCS standards including allergy skin testing and in office immunotherapy (Allergy shots /mixes)
- Insurance verification & Authorizations: Verify patient insurance eligibility, coverage limits and pre-authorizations prior to the scheduled clinic visits or immunotherapy programs.
- Denial & A/R Management: Review Claims rejections, denials and underpayments, research payor policies and submit formal appeals with the supporting medical records.
- Payment posting: Post patient payments, copayments, deductibles and adjustments into the EHR system.
- Patient Communication: Answer patient inquiries regarding bills, explain Explanation of Benefits (EOBs) and set up or manage payment plans.
- Clinical Collaboration: Work closely with providers, allergy nurses and clinical staff to resolve documentaion, charge capture or coding discrepancies.
- Compliance: Ensure all billing and coding practices adhere to HIPAA guidelines, federal healthcare regulations, and specific insurance payor policies.
Requirements
Experience: Generally 1-5 years of medical billing experience. Specialty or allergy /immunology experience preferred.
Knowledge base: Strong familiarity with medical billing software, EHR platforms and specialized allergen immunotherapy reimbursement guidelines