Account Executive

Role Overview

• Account Executives are subject matter experts of zero balance projects, conducting in depth research of hospital contracts, data, and other sources to address client questions.
• They manage external project relationships, which includes compiling and presenting reports and analysis.
• They also manage internal projects and assignments.
• Manage client projects and relationships by participating in meetings, managing action items through to completion, answering client questions, and independently writing client emails
• Compile, QA, and independently manage client processes from start to finish, such as provider relation escalations, bulk issues, regular reports, and invoices
• Manage internal staffing and project needs, including answering questions from other team members on assigned client and monitoring project profitability
• Research and determine next steps for complex and new payer issues and reimbursement areas to uncover potential opportunities, such as reimbursement guidelines and healthcare legislation
• Create and update project plans, including outlining potential risk areas of a hospital-payer contract based on reimbursement structure and how to manually identify within the data
• Review and summarize pricing documents based on hospital contracts to calculate expected payments, including Medicaid, percentage of charge, per diems, Medicare IPPS, MSDRG, outlier and/or stoploss, implants, drugs, and other reimbursement models
• Make thorough client observations and recommendations after completing a project audit regarding underpayment exposure, contract risk, and other potential issues
• Work with other account executives and managers to effectively submit bulk listings of accounts to insurance companies for reprocessing (e.g. rebill)
• Escalate accounts to insurance provider relations for resolution and payment, including corresponding appropriately with provider relations teams, tracking progress of issues and ensuring that deadlines are met
• Examine feedback from other internal teams on project activity and provide teams appropriate direction regarding account action when auditing and/or pursuing payments
• Contribute meeting content to team meetings, AC biweekly meetings, and internal project related meetings
• Help create and implement process improvements and trainings to protect future revenue
• Understands and implements best practices for internal processes, communication, and documentation

Requirements

• A minimum of 3 years of experience in areas of research and analysis
• A minimum of 3 years of verifiable work history
• A minimum of 3 years of experience with managed care contracts and hospital reimbursement
• A minimum of 2 years of experience working with clients or equivalent
• Must have achieved High School Diploma or GED
• 3 years of experience working in MS Office, with emphasis on advanced Excel skills, requiring experience with formulas, graphing, and reports to manipulate pricing tools and edit project reports
• Demonstrated problem solving and critical thinking skills
• Demonstrated ability to meet project deadlines
• Demonstrated excellent written and verbal communication skills, to include writing professional documents and delivering presentations.
• Diligent and strong attention to detail

Benefits

• We build long-term careers by investing in YOU.
• Flexible work arrangements
• Professional development opportunities