Account Rep II Workers Comp

Account Rep II

Position Description : As an Account Rep II, you will 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. Requires extensive use of multiple internal and external computer systems / applications and contact with the above entities. Hybrid Position : 90% Remote & 10% Onsite 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 as 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 registration and update corresponding Department 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 Account Rep I. Perform necessary billing activities such as claims to maintain team goals or assist other teams. Works special projects as assigned by supervisor. Knowledge - Skills - Abilities Knowledge of quality control, customer service standards, information management, procedural process, and recordkeeping. Computer, technical, interpersonal, oral communication, listening, and patience skills. Schedule : Full-time role with expectations for coverage during core business hours and flexibility required as necessary to accommodate business needs. Position Requirements : Minimum Qualifications : Appropriate experience may be substituted for education on an equivalent basis Minimum Required Education : High school diploma Minimum Required Experience : 2 years Preferred Qualifications : Customer Service and / or Medical Billing experience. Why MCW? Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options 403B Retirement Package Competitive Vacation and Paid Holidays offered Tuition Reimbursement Paid Parental Leave Pet Insurance On campus Fitness Facility, offering onsite classes. Additional discounted rates on items such as : ... For full info follow application link. EEO / AA Minorities / Females / Vets / Disability The Medical College of Wisconsin is an affirmative action / equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, veteran status, disability or sexual orientation.