Account Rep II Commercial Clinical

MCW: SARGEANT HEALTH CENTER • Milwaukee, WI • 1h ago

JOB REQUIREMENTS: Summary As anAccount Rep II on the Commercial team,you
will submit, post, and secure maximum allowable reimbursement from
third-party carriers, government programs and Health Maintenance
Organizations in the areas of claims submission and/or account
follow-up.Requires extensive use of multiple internal and external
computer systems/applications and contact with the above entities.
Hybrid position: 90% Remote, 10% Onsite, must live in Metro Milwaukee,
WI area. Primary Responsibilities Release of information: Reply to
requests for information from insurance companies. Pull the appropriate
medical records to submit for claims payment and ensure all proper
documentation is present and accurate. Apply extensive knowledge of
multiple contracts, agreements and government guidelines/regulations to
submit, post, research and/or resolve accounts or claims. Communicate
via phone with various representatives, both internally and externally
is necessary. Analyze multiple sources of remittance to determine proper
allocation of rejections, payments and/or adjustments, subject to
individual carrier guidelines and contractual fee schedules. Respond to
carrier requests for additional information or documentation. Review
carrier denials and/or unacceptable reimbursement to (a) challenge the
determination or (b) adjust appropriately. Review and update
registration to correspond with information received from payer. Copy
and forward remittance advice to appropriate team for follow-up.
Responsible for identifying and escalating contractual carrier issues to
the appropriate source. Assist training Clerks. Perform necessary
billing activities such as claims to maintain team goals or assist other
teams. Other duties as assigned.Knowledge - Skills - Abilities Knowledge
of quality control, customer service standards, information management,
procedural process, and recordkeeping. Computer, technical,
interpersonal, oral communication, listening, and patience skills.
Qualifications Minimum Required Education:High school diploma Minimum
Required Experience: 3 years Preferred Experience: Customer Service
and/or Medical Billing experience #LI-RT1 Why MCW? Outstanding
Healthcare Coverage, including but not limited to Health, Vision, and
Dental. Along with Flexible Spending options 403B Retirement Package
Competitive Vacation and Paid Holidays offered Tuition Reimbursement
Paid Parental Leave Employee & Family Assistance Program (EFAP) Pet
Insurance On campus Fitness Facility, offering onsite classes Additional
discounted rates on items such as: Select cell phone plans, local...
For full info follow application link. EEO/AA
Minorities/Females/Vets/Disability The Medical College of Wisconsin is
an affirmative action/equal opportunity employer and does not
discriminate in hiring or employment on the basis of age, sex, race,
color, religion, national origin, veteran status, disability or sexual
orientation. *** APPLICATION INSTRUCTIONS: Apply Online:
ipc.us/t/52F78AB01FD4402E Qualified females, minorities, and special
disabled veterans and other veterans are encouraged to apply.

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