Account Rep II, Medicare – Clinical Practice Services

MCW

Account Rep II responsible for claims submission and securing reimbursements from insurers. Requires 3 years experience and high school diploma, based in Wisconsin.

Posted 7/10/2026full-timeWauwatosa • Wisconsin • 🇺🇸 United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in claims submission and account follow-up, utilizing extensive knowledge of contracts, agreements, and government regulations. Proficient in analyzing remittance sources and communicating effectively with insurance representatives to resolve claims issues.

Highest-signal resume keywords

Claims SubmissionMedical Billing ExperienceEPIC ExperienceCustomer ServiceRegulatory Knowledge

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingAccount Follow-UpDocumentation AccuracyRemittance AnalysisContractual Guidelines

Soft Skills

CommunicationProblem-SolvingTeam Collaboration

Tools & Technologies

Computer SystemsInternal ApplicationsExternal Applications

Industry Keywords

Health Maintenance OrganizationsThird-Party CarriersGovernment ProgramsInsurance Companies

About the role

Key responsibilities & impact

As an Account Rep II, you will submit, post, and secure maximum allowable reimbursement from third-party carriers, government programs and Health Maintenance Organizations in the areas of claims submission and/or account follow-up.
Requires extensive use of multiple internal and external computer systems/applications and contact with the above entities.
Hybrid Work Arrangement: 90% Remote, 10% onsite, must reside in the metro Milwaukee, WI area.
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 experience.
EPIC experience preferred.

Benefits

Comp & perks

Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental.
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.