Remote Healthcare Billing & Claims Rep II

Medical College of Wisconsin; Wauwatosa (WI); Hybrid; USD 42,000 - 64,000; Full time

Benefits offered by this job

Health coverage

403B retirement package

Vacation and holidays

Tuition reimbursement

EFAP

Pet insurance

On campus fitness facility

Discounted rates on local services

Job summary

Medical College of Wisconsin in the Milwaukee metro area seeks an Account Rep II on the Commercial team to submit, post, and secure maximum reimbursements from third-party carriers and government programs. You will handle claims and follow-up across multiple systems, ensuring accuracy and compliance with payer requirements.

The role is a hybrid work arrangement (90% remote, 10% onsite) and requires residing in the metro Milwaukee, WI area.

Qualifications

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

Responsibilities

• Release of information: reply to requests for information from insurance companies and pull records for claims submission.
• Submit, post, and research accounts or claims using multiple contracts and government regulations.
• Communicate via phone with internal and external representatives as needed.
• Analyze remittance sources to allocate rejections, payments, and adjustments per carrier guidelines.
• Respond to carrier requests for additional information or documentation.
• Review denials and adjust or challenge determinations as appropriate.
• Update registrations to align with payer information.
• Copy and forward remittance advice to the appropriate team for follow-up.
• Identify and escalate contractual carrier issues to the proper source.
• Perform billing activities to support team goals and assist other teams.
• Other duties as assigned.

Skills

Quality control

Customer service

Information management

Procedural knowledge

Recordkeeping

Oral communication

Listening

Patience

Education

High school diploma

Tools

EPIC

Job description

Medical College of Wisconsin in the Milwaukee metro area seeks an Account Rep II on the Commercial team to submit, post, and secure maximum reimbursements from third-party carriers and government programs. You will handle claims and follow-up across multiple systems, ensuring accuracy and compliance with payer requirements.

The role is a hybrid work arrangement (90% remote, 10% onsite) and requires residing in the metro Milwaukee, WI area.