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Account Representative II Commercial
4 weeks ago
At MCW: SARGEANT HEALTH CENTER, we are seeking a highly skilled Account Representative II Commercial to join our team. As an Account Representative II Commercial, you will play a critical role in submitting, posting, and securing maximum allowable reimbursement from third-party carriers, government programs, and Health Maintenance Organizations in the areas of claims submission and/or account follow-up.
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.
- 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.
- Copy and forward remittance advice to appropriate team for follow-up.
- Identify and escalate 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.
- Appropriate experience may be substituted for education on an equivalent basis.
- High school diploma.
- Minimum Required Experience: 3 years.
At MCW: SARGEANT HEALTH CENTER, we offer a comprehensive benefits package, including outstanding healthcare 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.
We are an affirmative action/equal opportunity employer and do not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, veteran status, disability, or sexual orientation.
