Account Executive

📋 Description

• Account Executives serve as subject matter experts on zero balance projects, performing comprehensive research on hospital contracts, data, and various sources to address client inquiries.

• They oversee external project relationships, which entails compiling and delivering reports and analyses.

• Additionally, they manage internal projects and assignments.

• Handle client projects and relationships by engaging in meetings, managing action items to completion, addressing client questions, and independently composing client emails.

• Compile, quality assure, and autonomously manage client processes from inception to completion, including provider relation escalations, bulk issues, routine reports, and invoices.

• Manage internal staffing and project requirements, including responding to inquiries from team members regarding assigned clients and monitoring project profitability.

• Research and identify next steps for complex and novel payer issues and reimbursement areas to uncover potential opportunities, such as reimbursement guidelines and healthcare legislation.

• Create and update project plans, detailing potential risk areas of hospital-payer contracts based on reimbursement structures and methods to manually identify within the data.

• Analyze and summarize pricing documents based on hospital contracts to estimate expected payments, including Medicaid, percentage of charge, per diems, Medicare IPPS, MSDRG, outlier and/or stoploss, implants, drugs, and other reimbursement frameworks.

• Provide thorough client observations and recommendations following a project audit regarding underpayment exposure, contract risk, and other potential concerns.

• Collaborate with other account executives and managers to efficiently submit bulk listings of accounts to insurance companies for reprocessing (e.g., rebill).

• Escalate accounts to insurance provider relations for resolution and payment, ensuring appropriate correspondence with provider relations teams and tracking progress to meet deadlines.

• Review feedback from other internal teams on project activities and guide teams on appropriate account actions during audits and/or payment pursuits.

• Contribute to meeting agendas for team meetings, biweekly AC meetings, and internal project-related meetings.

• Assist in developing and implementing process enhancements and training programs to safeguard future revenue.

• Understand and apply best practices for internal processes, communication, and documentation.

⛳️ Requirements

• A minimum of 3 years of experience in research and analysis.

• At least 3 years of verifiable work history.

• A minimum of 3 years of experience with managed care contracts and hospital reimbursement.

• At least 2 years of experience working directly with clients or equivalent.

• Must possess a High School Diploma or GED.

• Three years of experience working with MS Office, with a focus on advanced Excel skills, including proficiency in formulas, graphing, and reports for manipulating pricing tools and editing project reports.

• Proven problem-solving and critical thinking abilities.

• Demonstrated capability to meet project deadlines.

• Exceptional written and verbal communication skills, including the ability to craft professional documents and deliver presentations.

• Strong attention to detail and diligence.

🏝️ Benefits

• We invest in YOU to build long-term careers.

• Flexible work arrangements available.

• Opportunities for professional development.