Account Manager

Summary

Join our team as an Account Specialist and manage the operations and escalations of assigned client accounts. You will be responsible for triaging, evaluating, and resolving inquiries related to MedReview audit activity. This role involves collaborating with internal and external stakeholders to investigate audit activity, status, outcomes, and requests. You will guide the resolution of escalations, serve as the primary point of contact for inquiries, and work with internal departments to advance tasks and resolve account issues. The position requires experience in healthcare claims processing and strong analytical and communication skills. We offer a competitive salary and benefits package, including healthcare, 401k matching, generous PTO, wellness programs, and professional development opportunities.

Requirements

• 3-5+ years’ experience in healthcare claims processing and/or billing, particularly inpatient claims
• Strong working knowledge of Microsoft Office, particularly Excel and Word
• Experience in developing trusting and collaborative internal and client stakeholders-relationships
• Proven ability to manage multiple case inquiries/escalations with strong attention to detail
• Analytical skills demonstrating ability to collect, track and analyze data
• Professional oral and written communication skills, particularly via email
• High speed internet (100 Mbps per person recommended) with secured WIFI
• A dedicated workspace with minimal interruptions to protect PHI and HIPAA information
• Must be able to sit and use a computer keyboard for extended periods of time

Responsibilities

• Understand the MedReview review service types and end-to-end workflow process details
• Assist client stakeholders in understanding all stages of the MedReview audit process
• Guide resolution of assigned escalations and inquiries to appropriate & timely resolution
• Serve as the primary point of contact for such audit inquiries or escalations for MedReview internal teams and client stakeholders for specified clients and/or sub-clients
• Work with internal departments to ensure advancement of tasks and resolution of account issues
• Analyze and track key audit data for escalated cases to include: Optimal flow of the Audit Continuum (e.g., timely file receipt and completeness, medical record flow, provider exclusions, client savings file return)
• Financial review of audit outcomes
• Interact with the Customer Service Department staff to inform and educate on client logistics (location, type, number of plans)
• Interact with Request for Information (ROI) Department as necessary to address submission issues or delays as well as proactively inform ROI staff of client nuances

Preferred Qualifications

• Bachelor’s degree
• Comfort in learning and operating in multiple software applications
• Experience and knowledge with healthcare claims payment integrity

Benefits

• Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents
• 401(k) with Employer Match - Join the team and we will invest in your future
• Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays
• Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered
• Learning & Development - Through continued education/mentorship on the job and our investment in LinkedIn Learning, we’re focused on your growth as a working professional