Account Rep II Medicare Clinical

MEDICAL COLLEGE OF WISCONSIN INC. • Milwaukee, WI • 1h ago

JOB REQUIREMENTS: Summary As anAccount Rep II,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 Work Arrangement: 90% Remote, 10%
onsite, must reside in the 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. EPIC experience preferred. #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... 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/C6784BF3B3AC4E2A Qualified females,
minorities, and special disabled veterans and other veterans are
encouraged to apply.

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