Account Representative II

7 days ago


Milwaukee, Wisconsin, United States MCW: SARGEANT HEALTH CENTER Full time
Job Summary

We are seeking a highly skilled Account Representative II - Commercial to join our team at MCW: SARGEANT HEALTH CENTER. This role will be responsible for 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.

Key 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 and resolution of issues.
  • 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 accordingly.
  • 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 to ensure knowledge transfer and continuity.
  • Perform necessary billing activities, such as claims, to maintain team goals or assist other teams.
Requirements
  • Appropriate experience may be substituted for education on an equivalent basis.
  • Minimum Required Education: High school diploma.
  • Minimum Required Experience: 3 years.
Why Join Our Team?

At MCW: SARGEANT HEALTH CENTER, we offer a comprehensive benefits package, including:

  • Outstanding Healthcare Coverage, including Health, Vision, and Dental.
  • Flexible Spending options.
  • 403B Retirement Package.
  • Competitive Vacation and Paid Holidays.
  • Tuition Reimbursement.
  • Paid Parental Leave.
  • Pet Insurance.
  • On-campus Fitness Facility, offering 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.



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