Remote Account Rep II - Claims & Reimbursement

Medical College of Wisconsin; Wauwatosa (WI); Hybrid; USD 42,000 - 60,000; Full time

Benefits offered by this job

Healthcare benefits

403B retirement package

Competitive vacation and holidays

Tuition reimbursement

Paid parental leave

EFAP

Pet insurance

On campus fitness facility

Discounts on cell plans and local ent.

Job summary

Medical College of Wisconsin is seeking an Account Rep II on the Commercial team to submit, post, and secure maximum reimbursement from third-party carriers and government programs for claims submission and follow-up.

Hybrid arrangement: 90% remote, 10% onsite in the metro Milwaukee area; reside in Wisconsin. The role involves carrier communications, remittance analysis, registration updates, and supporting billing activities to achieve team goals.

Qualifications

• High school diploma required.
• 3 years minimum experience.
• Preferred: Customer Service and/or Medical Billing.
• EPIC experience preferred.

Responsibilities

• 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.

Skills

Quality control

Customer service standards

Information management

Procedural process

Recordkeeping

Computer skills

Interpersonal skills

Oral communication

Listening

Patience

Education

High school diploma

Job description

Medical College of Wisconsin is seeking an Account Rep II on the Commercial team to submit, post, and secure maximum reimbursement from third-party carriers and government programs for claims submission and follow-up.

Hybrid arrangement: 90% remote, 10% onsite in the metro Milwaukee area; reside in Wisconsin. The role involves carrier communications, remittance analysis, registration updates, and supporting billing activities to achieve team goals.