PCG Consulting Group International
Guiding B2B solutions through expertise and dedication.
Medical Account Representative
Account ManagerSalesFull TimeRemoteMid LevelTeam 201-500Since 2004H1B No SponsorCompany SiteLinkedIn
Location
Illinois
Posted
174 days ago
Salary
$18 - $23 / hour
Seniority
Mid Level
2 yrs expEnglish
Job Description
• Manage a portfolio of zero-balance inpatient/outpatient accounts, focusing on high charge to low reimbursement opportunities for additional revenue
• Maximize collections by resolving billing errors and disputing/appealing underpayments
• Prepare and submit medical claims to third-party insurance carriers electronically or by hard copy
• Follow up with third-party insurance carriers and patients until claims are paid correctly
• Investigate and identify trends to resolve billing errors, underpayments, and discrepancies within multiple payor portals
• Communicate with insurance companies to resolve account-related issues promptly
• Conduct audits and identify trends in high-dollar inpatient and outpatient accounts
• Work cross-functionally with internal teams to prioritize worklists and resolve high-value accounts quickly and accurately
Job Requirements
- 2+ years of inpatient institutional billing experience, preferably with IL Medicaid and Medicare Advantage plans
- Strong understanding of IL Medicaid, Medicare, MCOs, and state-specific regulations
- Ability to audit accounts and identify trends in insurance underpayments
- Experience reading and interpreting EOBs, UB04s, Remittance Images
- Experience disputing/appealing/escalating claim issues/denials with insurance companies
- Familiarity with revenue cycle management software and account auditing tools
- Excellent organizational, analytical, and communication skills
- Meticulous attention to detail
- Ability to work independently and as part of a team
- Proactive learner with ability to quickly grasp new computer programs and websites
- Strong problem-solving abilities
- Preferred: Knowledge of CPT/ICD-10 coding and experience with institutional claim processes, Assurance, Siemens OAS Gold, Powerchart, Medi
Benefits
- Dental insurance
- Health insurance
- Paid time off
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