Account Representative II
7 days ago
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.
- Appropriate experience may be substituted for education on an equivalent basis.
- Minimum Required Education: High school diploma.
- Minimum Required Experience: 3 years.
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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