Account Representative

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. Require extensive use of multiple internal and external computer systems/applications and contact with the above entities. Hybrid Work Arrangement: 90% Remote, 10% onsite, must reside in the metro Milwaukee, WI area. Release of information: Reply to requests for information from insurance companies. Pull the appropriate medical records to submit for claims payment and ensure all proper documentation is present and accurate. 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 is necessary. 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 (a) challenge the determination or (b) adjust appropriately. Review and update registration to correspond with information received from payer. Copy and forward remittance advice to appropriate team for follow-up. Responsible for identifying and escalating 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. Other duties as assigned. Requirements Minimum Required Education: High school diploma Minimum Required Experience: 3 years Preferred Experience: Customer Service and/or Medical Billing experience. EPIC experience preferred. Core Competencies Demonstrates expertise in claims submission and account follow-up, utilizing extensive knowledge of contracts, agreements, and government regulations. Proficient in analyzing remittance sources and communicating effectively with insurance representatives to resolve claims issues. Highest-signal resume keywords Claims Submission Medical Billing Experience EPIC Experience Customer Service Regulatory Knowledge Hard Skills Claims Processing Account Follow-Up Documentation Accuracy Remittance Analysis Contractual Guidelines Soft Skills Communication Problem-Solving Team Collaboration Industry Keywords Health Maintenance Organizations Third-Party Carriers Government Programs Insurance Companies Tools & Technologies Computer Systems Internal Applications External Applications #J-18808-Ljbffr