Account Rep II – Clinical Practice Services

MCW

Account Rep II handling HMO claims submission and follow-up. Requires extensive knowledge of contracts and communication with insurance entities in a hybrid role.

Posted 6/5/2026full-timeMilwaukee • Wisconsin • 🇺🇸 United StatesMid-LevelSeniorWebsite

About the role

Key responsibilities & impact

Release of information: Reply to requests for information from insurance companies.
Pull the appropriate medical records to submit for claims payment and ensure all proper documentation is present and accurate.
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 is 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 and update registration to correspond 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 Clerks.
Perform necessary billing activities such as claims to maintain team goals or assist other teams.
Other duties as assigned.

Requirements

What you’ll need

Minimum Required Education: High school diploma
Minimum Required Experience: 3 years
Preferred Experience: Customer Service and/or Medical Billing/Follow-Up experience. EPIC experience preferred.

Benefits

Comp & perks

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
Employee & Family Assistance Program (EFAP)
Pet Insurance
On campus Fitness Facility, offering onsite classes
Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

medical billingclaims processingdocumentation accuracyremittance analysiscontractual compliancebilling activitiescustomer service

Soft Skills

communicationanalytical thinkingproblem-solvingteam collaborationtraining