PCG Consulting Group International logo
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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