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Commercial Account Representative II
2 months ago
We are seeking a highly skilled Commercial Account Representative II to join our team at MCW: SARGEANT HEALTH CENTER. As a key member of our revenue cycle team, you will play a critical role in ensuring timely and accurate reimbursement from third-party carriers, government programs, and Health Maintenance Organizations.
Key Responsibilities- 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.
- 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 resolve issues and obtain necessary information.
- 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.
- Minimum Qualifications: High school diploma and 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.
At MCW: SARGEANT HEALTH CENTER, we offer a competitive benefits package, including outstanding healthcare coverage, flexible spending options, and a 403B retirement package. We also offer tuition reimbursement, paid parental leave, and pet insurance. Our on-campus fitness facility offers onsite classes, and we provide discounted rates on select cell phone plans. If you are a motivated and detail-oriented individual who is passionate about delivering exceptional customer service, we encourage you to apply.
