Remote Claims Account Rep II – Med Billing

The Medical College of Wisconsin, Inc.; Wauwatosa (WI); Hybrid; USD 48,000 - 68,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Paid time off

Tuition reimbursement

Onsite fitness facility

Retirement plan

Job summary

The Medical College of Wisconsin, Inc. is seeking an Account Rep II to manage claims submission and posting to maximize reimbursements from third-party carriers and government programs.

The role requires extensive use of internal and external systems and interaction with payer entities, within a hybrid schedule (90% remote, 10% onsite) in the metro Milwaukee area. Responsibilities include handling requests for information, reviewing remittances, and resolving denials per carrier guidelines.

Qualifications

• High school diploma required; 3 years of relevant experience preferred.
• Customer service and medical billing experience preferred.
• EPIC experience preferred.

Responsibilities

• Submit, post, and secure maximum allowable reimbursement from third-party carriers and government programs.
• Release of information: pull medical records for claims payment and ensure documentation is present and accurate.
• Analyze remittance to determine proper allocation of rejections, payments and adjustments per carrier guidelines.
• Communicate with insurance representatives by phone as needed.
• Respond to carrier requests for additional information or documentation.
• Review denials and/or unacceptable reimbursement to challenge or adjust as appropriate.
• Update registrations to reflect payer information.
• Assist training Clerks and perform necessary billing activities.
• Escalate contractual carrier issues to the appropriate source.
• Other duties as assigned.

Skills

Customer service

Communication skills

Attention to detail

Interpersonal skills

Education

High school diploma

Tools

EPIC

Job description

The Medical College of Wisconsin, Inc. is seeking an Account Rep II to manage claims submission and posting to maximize reimbursements from third-party carriers and government programs.

The role requires extensive use of internal and external systems and interaction with payer entities, within a hybrid schedule (90% remote, 10% onsite) in the metro Milwaukee area. Responsibilities include handling requests for information, reviewing remittances, and resolving denials per carrier guidelines.