Medical Account Representative

Job not on LinkedIn

September 26

🌽 Illinois – Remote

Although this job is listed in Illinois, this company may be open to hiring remote in other states.

💵 $18 - $23 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

💰 Account Manager

🚫👨‍🎓 No degree required

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PCG Consulting Group International

WebsiteLinkedInAll Job Openings

Healthcare Insurance • IT • Consulting

PCG Consulting Group International is a consulting firm specializing in providing scalable solutions in the fields of Healthcare, IT, and Project Management. They focus on delivering practical and effective solutions that help organizations achieve their goals. As a Minority Business Enterprise (MBE) and a member of the Illinois Business Enterprise Program, PCG prides itself on its diverse team of data experts and experienced professionals. They offer a wide range of services, including IT services, security and compliance, data services, healthcare solutions, and more. PCG is also certified in HITRUST compliance and PCI, ensuring a strong commitment to safeguarding business interests. Their approach as problem solvers and trusted advisors helps clients navigate the complex business landscape effectively.

201 - 500 employees

Founded 2004

⚕️ Healthcare Insurance

📋 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

🎯 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