Account Representative II
3 hours ago
Join the Medical College of Wisconsin (MCW) team as an Account Representative II, where you will play a crucial role in submitting, posting, and securing maximum allowable reimbursement from third-party carriers, government programs, and Health Maintenance Organizations.
Responsibilities:- 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, to ensure seamless communication.
- 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, and review carrier denials and/or unacceptable reimbursement to challenge the determination or adjust appropriately.
- Review and update registration to correspond with information received from payer, and copy and forward remittance advice to appropriate team for follow-up.
- Identify and escalate contractual carrier issues to the appropriate source, and assist in training Clerks.
- Perform necessary billing activities, such as claims, to maintain team goals or assist other teams.
- High school diploma
- Minimum 3 years of experience in a related field
- Knowledge of quality control, customer service standards, information management, procedural process, and recordkeeping
- Computer, technical, interpersonal, oral communication, listening, and patience skills
MCW offers a comprehensive benefits package, including health, vision, and dental coverage, flexible spending options, 403B retirement package, competitive vacation and paid holidays, tuition reimbursement, paid parental leave, pet insurance, and on-campus fitness facility with onsite classes.
Additionally, MCW provides discounted rates on select cell phone plans and other benefits. 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.
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