Top 17078 Senior account representative Jobs in United States

Account Manager – Dialysis Claims & Payment Solutions
Innovative Healthware Services, Inc. DBA ClaimsBridge —Arnold, MD
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- Microsoft Excel
- Microsoft Outlook
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- Health insurance
- Dental insurance
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Account Manager – Dialysis Claims & Payment Solutions

Innovative Healthware Services, Inc. DBA ClaimsBridge
Arnold, MD

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Job Details

Full-time
$90,000 - $105,000 a year
3 hours ago

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance
401(k) matching
Life insurance

Qualifications

Healthcare dispute resolution
Pricing
Microsoft Excel
Microsoft Outlook
Payment processing
Insurance dispute resolution
Presentations for conferences or internal meetings
Account development
Bachelor's degree
Health insurance knowledge
Client services
Customer relationship management
Organizational skills
Account management
Payment processing in medical billing systems

Full Job Description

ClaimsBridge Account Manager – Dialysis Claims & Payment Solutions

Summary

In the role of Account Manager (AM), you will be responsible for building strategic client relationships and establishing client retention strategies, with a specific focus on clients utilizing Dialysis PPO cost containment solution. This role should seek to constantly look for ways to build additional value for clients and improve client satisfaction metrics. The AM identifies ways of increasing revenue opportunities and executes projects to implement purchased solutions, while serving as the subject matter expert on dialysis claim adjudication, pricing, and payment workflows across the ESRD provider network.

Duties and Responsibilities

Acts as the client's primary liaison, conducting client meetings to build a solid relationship with client executives and staff.
Understands and tracks the performance goals, trends, overall service results, and recommends actions to improve performance and mitigate risks, with particular attention to dialysis claim throughput, pricing accuracy, and payment turnaround times.
Builds successful renewal strategies/client care plans that reflect knowledge of the client business, healthcare plan trends, dialysis network and reimbursement structures, and performance reporting to identify opportunities and reinforce the value proposition for the client.
Understands and presents new product updates and modules to clients, including enhancements to dialysis claims and payment processing capabilities.
Manages the onboarding process of new products and services, including dialysis claim routing, pricing, and payment integration workflows.
Manages projects for enhancement and/or new product set-up for existing clients.
Serves as an internal and client-facing resource on dialysis claim payment methodologies (e.g., Medicare ESRD PPS, composite rate, bundled/case-mix adjustments) and how they are applied within ClaimsBridge's pricing and adjudication infrastructure.
Maintains working knowledge of large dialysis organization (LDO) payer relations and network arrangements (e.g., DaVita, Fresenius Kidney Care/Fresenius Medical Care, U.S. Renal Care, American Renal Associates) and how these relationships affect claim pricing, routing, and payment resolution.
Increases the perceived value of ClaimsBridge products and services through on-going education, with emphasis on dialysis claims processing and payment integrity.
Communicates with and manages other key stakeholders effectively: i.e. brokers, TPA account managers, dialysis network partners, and sales representatives.
Collaborates with internal colleagues (claims operations, network management, IT) to ensure the highest level of service delivery for dialysis claim processing and to address potential issues.
Solicits and manages client feedback and communicates client requests throughout the company.
Monitors the resolution and documentation of escalated client issues, including disputes or discrepancies related to dialysis claim pricing and payment.
Maintains customer database to include: demographics, utilization, satisfaction level, key contacts, and benchmarking goals.
Other duties as assigned.

Required Experience and Education

Bachelor's degree
5+ years Healthcare IT or Medical Insurance Carrier experience
3+ years of direct experience with dialysis claim adjudication and payment processes, including hands-on familiarity with ESRD PPS, composite rate, and bundled/case-mix payment methodologies
Prior experience working with or managing relationships involving large dialysis organizations (LDOs) and their payer contracting/claims teams (e.g., DaVita, Fresenius Kidney Care, U.S. Renal Care, American Renal Associates) strongly preferred
Knowledge of Healthcare Claims processing and/or Healthcare Contracts
5+ years of Client Service experience

Summary of Essential Job Functions

Strong interpersonal and communication skills, making presentations to an internal audience and interacting positively with the senior level of the client's management team.
Independent problem solving and self-direction are critical.
Comfortable with managing resources toward a specific goal.
Understanding and experience with workflow and business process analysis in a large physician or dialysis provider organization.
Working knowledge of the dialysis claim lifecycle: submission, pricing, adjudication, payment, and dispute resolution, including coordination with ESRD network and LDO payer relations contacts.
Works well in a team-oriented structure to achieve goals.
Knowledge of the patient flow, reimbursement process, and insurance plan configuration design within a health care setting, particularly as it relates to renal/dialysis care.
Ability to travel as needed up to 30%.
Computer skills which include proficiency in Microsoft Outlook, Word, Excel, and PowerPoint, as well as navigation utilizing the internet.
Ability to demonstrate a commitment to building new skills and fostering a positive work environment.

About ClaimsBridge

ClaimsBridge is a healthcare technology cost containment company providing custom and high performing networks, Medicare pricing solutions, and unified end-to-end preadjudication infrastructure for the receipt, routing, and pricing of medical claims, including dialysis claims. ClaimsBridge is directly connected to over 120 partners serving self-funded and fully insured employers through their broker and benefit consultants, stop-loss carriers, third-party administrators, healthcare networks, and strategic vendor partners. For more information about ClaimsBridge service offerings, visit www.claimsbridge.com or call 410.349.3222.

Pay: $90,000.00 - $105,000.00 per year

Benefits:

401(k) matching
Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Application Question(s):

How many years of Healthcare IT or Medical Insurance Carrier experience do you have? (0-2 / 3-4 / 5+)
How many years of direct, hands-on experience with dialysis claim adjudication and payment processes do you have? (0 / 1-2 / 3+)
How many years of client service / account management experience do you have? (0-2 / 3-4 / 5+)
Have you had experience with account management with C-Suite level or Executive level relationship management? If yes, please explain.
Have you worked directly with, or managed relationships involving, large dialysis organizations (LDOs) such as DaVita, Fresenius Kidney Care/Fresenius Medical Care, U.S. Renal Care, or American Renal Associates? If yes, describe your role and the nature of the relationship (payer contracting, claims, network management, etc.)

Work Location: In person

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Refine Your Search

senior account representative jobs in united states

Account Manager – Dialysis Claims & Payment Solutions

Senior Manufacturing Engineer

Remote Regional Healthcare Senior Finance Manager - TxO San Antonio Region

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Underwriter, Senior

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