MedReview Inc Hiring for Account Manager, Validation Review at Manhattan, NY Full Time

The Account Manager, Validation Review role is responsible for the operations and analytical oversight of assigned client accounts, overseeing the client relationship of each account, and identifying issues and opportunities for optimized savings. Account oversight includes management of effective operations within each of the review continuum components by anticipating and resolving operations issues and collaborating with internal teams.

Responsibilities and Duties:

• Understand the MedReview review service types and end-to-end process details so as to:
• Assist the client understand all stages of the review process
• Proactivity identify operations issues to mitigate potential problems
• Conduct analysis of key performance indicators to ensure effective operations
• Guide resolution of issues resulting from client files (e.g., timing, field, accuracy)
• Serve as the primary point of contact for the MedReview internal teams and client as well as the liaison between the client and internal teams
• Communicate regularly with clients to understand operation needs, build mutual account knowledge and develop a trust relationship through demonstrated delivery consistency
• Ensure timely and successful resolution of client issues
• Work with internal departments, particularly Medical Information Services and Information Technology, to ensure advancement of tasks and resolution of account issues
• Analyze and track key account data to understand important metrics to include:
• Optimal flow of the Review Continuum (e.g., timely file receipt and completeness, medical record flow, provider exclusions, client savings file return)
• Key Savings Performance indicators (e.g., Denial %, Savings, Aged savings, High-frequency Providers)
• Financial review of revenue and accounts receivable
• Communicate regular Key Savings Performance Indicator to Senior leadership
• Validate and communicate invoice content information for Finance Department
• Prepare and present Weekly Account Status and Issues Log to leadership team
• Interact with the Customer Service Department staff to inform and educate on account logistics (location, type, number of plans) in preparation for customer inquiries
• Understand the frequency and type of Customer Service inquiries occurring per account
• Interact with Request for Information (ROI) Department as necessary to address submission issues or delays as well as proactively inform ROI staff of client nuances
• Actively participate in new client implementations to ensure advancement of process improvements, mitigate potential reoccurring operations issues, understand new account details, and build client relationship
• Communicate potential opportunities for add-on review work with existing accounts

Qualifications:

Required:

• 5+ years of proven account management experience, preferably within health insurance or healthcare provider revenue cycle
• Knowledge and experience in healthcare claims processing
• Experience in developing trusting and collaborative client-relationships
• Strong working knowledge at Microsoft Office, particularly Excel and Word
• Proven ability to manage multiple accounts with strong attention to detail
• Analytical skills demonstrating ability to collect, track and analyze data
• Excellent verbal, written skills and presentation skills (to include PowerPoint)
• Demonstrated ability to communicate, collaborate and advance solutions and strategy effectively at all levels within the organization and with the client
• Bachelor’s Degree preferred
• Ability to develop trusting relationships at all levels of an organization

Preferred:

• Ability to adapt quickly learn use of payment integrity vendor management software applications
• Experience and knowledge with healthcare claims payment integrity
• Understanding of basic financial operations, invoicing and accounts receivable management

Salary range $80K – $100K

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