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Top 50 Account Management Representative Skills

Below we've compiled a list of the most important skills for an Account Management Representative. We ranked the top skills based on the percentage of Account Management Representative resumes they appeared on. For example, 10.5% of Account Management Representative resumes contained Customer Service as a skill. Let's find out what skills an Account Management Representative actually needs in order to be successful in the workplace.

These are the most important skills for an Account Management Representative:

1. Customer Service

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high Demand
Here's how Customer Service is used in Account Management Representative jobs:
  • Manage severely delinquent charged off auto accounts while utilizing collection tools and procedures to resolve serious collection and customer service problems.
  • Assisted customers with problem resolution maintaining high level of customer service and satisfaction.
  • Provided customer service and assisted domestic and international customers assigned to me.
  • Interacted and supervised customer service representatives in a telephone based environment.
  • Provided exceptional customer service in a CallCenter environment.
  • Provided excellent customer service in a demanding environment.
  • Used excellent customer service skills to assist clients in making payments or payment arrangements and ensuring business objectives were met.
  • Optimized customer satisfaction by multiple and various accolades and a customer service award by a high-end customer.
  • Delivered excellent and professional customer service and manage accounts within the United States and Canada.
  • Provide excellent customer service to members and providers by explaining contracts and benefits.
  • Handled all customer service concerns from basic account questions to extensive billing issues.
  • Answered customer service inquiries about products and services offered by the bank.
  • Used customer service skills and knowledge of account history to assist customers.
  • Maintain knowledge of products and procedures to provide quality customer service.
  • Provided timely and efficient customer services to inquiries and requests.
  • Provide customer service after thourough research and analysis to assist customers with the correct means and resources to be compliant.
  • Delivered excellent customer service while working with clients on a daily basis for various new and on-going projects.
  • Adhere to all applicable ISO procedures Provide the best in Customer Service and Satisfaction.
  • Initiate and submit prior authorizations Accomplishments Received a shining star reward for great customer service!
  • Account billing and invoicing, Customer product sales and .Customer service, handles customer account inquiries and .

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6 Customer Service Jobs

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2. Provider Finder

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Here's how Provider Finder is used in Account Management Representative jobs:
  • Conducted thorough radius search in Provider Finder and followed up with the provider on referrals given.

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2 Provider Finder Jobs

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3. Data Entry

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Here's how Data Entry is used in Account Management Representative jobs:
  • Performed identification and data entry of referral requests.
  • Performed quality control of the data entry system to verify that claims and payments were posted correctly.
  • Processed and data entry of clients proposal agreement for financial debt and working with consumer credit counseling.
  • Handled data entry and general ledger work as well as bookkeeping and general clerical tasks.
  • Use of data entry computer program on a daily basis to track and update account.
  • Worked on Data entry and fax intakes for hospitals and doctors office.
  • Identified and performed data entry of referral requests into the UM system.
  • Train 62 new staff members in data entry of proposals.
  • Answered phones, inputted data entry, and utilized QuickBooks.
  • Oversee payments from customers through data entry software.
  • Perform data entry and post co-payments.

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1 Data Entry Jobs

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4. Phone Calls

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Here's how Phone Calls is used in Account Management Representative jobs:
  • Answered telephone calls regarding inquiries about requesting medical records and forwarded phone calls regarding other customer service matters to other departments.
  • Performed outbound/Inbound phone calls or write e-mails correspondence to obtain missing and unclear application information to complete the contract issue process.
  • Operated the Co-pay Management System including making outgoing phone calls to notify patients of balances due.
  • Answered 50 or more inbound telephone calls per day addressing account or technical support inquiries.
  • Receive incoming telephone calls or receive written inquiries, faxes or voice mails.
  • Receive complaints via Social Media, Email, and phone calls.
  • Received incoming and outgoing phone calls on multiple phone lines.
  • Make phone calls to clients daily regarding their contracts.
  • Received and placed telephone calls in professional manner.
  • Answer phone calls, handle customer inquiries.
  • Answer phones and direct patient phone calls.
  • Receive phone calls and provide information/results.
  • Transferred phone calls to various departments.
  • Adjusted accounts in response to phone calls and 1040X cases.Kansas City, MO.

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5. Authorization Review

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Here's how Authorization Review is used in Account Management Representative jobs:
  • Coordinate cases for pre-certification and prior authorization review while managing incoming calls, opening of cases and authorizing sessions.
  • Coordinate for pre certification and prior authorization review.
  • Coordinated cases for precertification and prior authorization review.
  • Provide customer support to Blue Cross Sr. Members Responsible for coordinating cases for precertification and prior authorization review

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4 Authorization Review Jobs

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6. Financial Statements

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Here's how Financial Statements is used in Account Management Representative jobs:
  • Prepared financial statements for internal and external use.
  • Prepared financial statements and maintain bookkeeping system.
  • Prepare accounting reports and financial statements.
  • Determined client needs through review of existing coverage and analysis of client financial statements.

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7. Inpatient Admissions

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Here's how Inpatient Admissions is used in Account Management Representative jobs:
  • Conducted prospective reviews to determine the medical necessity of inpatient admissions & outpatient services.
  • Maintained individual case load; monitoring inpatient admissions for timely discharge and appropriate aftercare.

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8. Insurance Companies

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Here's how Insurance Companies is used in Account Management Representative jobs:
  • Provide excellent customer service and professional communications with patients, insurance companies and other affiliates of the hospital.
  • Maintained effective communication and coordination between doctor's office, insurance companies, patients and medical delivery.
  • Contacted various health insurance companies to determine benefit plans for specific medications.
  • Send insurance companies additional information when requested to ensure prompt payment.
  • Follow up representative to insurance companies regarding payment/denial.
  • Contacted insurance companies to determine claim history.
  • Complete the account receivable lists for the various assigned insurance companies such as Allstate to ensure positive end of month goals.
  • Selected to service contract fulfillment issues as corporate liaison to health insurance companies and all New West office sites.
  • Handled multiple telephone requests from doctor offices, hospital administrators, insurance companies and clients.
  • Submit claims and appeals for payment to insurance companies that denied claim for unjust cause.
  • Provide customer service to patients who have account questions as well as insurance companies.
  • Contacted insurance companies to asses, review, adjust and reconcile claim disputes.
  • Verify patient health coverage with various insurance companies via website and telephone.
  • Appeal claims denied by Insurance Companies on patients' behalf Manage Department Accounting
  • Submitted electronic and paper health claims to various insurance companies.
  • Mail primary and secondary claims to insurance companies.
  • Maintain refunds to patients and Insurance companies.
  • Call Insurance companies regarding outstanding claims.
  • Coordinated and Managed Home Health Aides Assisted with insurance eligibility, requested authorizations with various insurance companies.
  • Refined processes to increase accounts receivables from insurance companies in a timely manner.

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9. Benefit Eligibility

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Here's how Benefit Eligibility is used in Account Management Representative jobs:
  • Authorize or deny request for participating providers and single case agreements, based on member s benefit eligibility and medical necessity.
  • Managed electronic faxes and incoming post services claims work and determined contract and benefit eligibility.
  • Determine contract and benefit eligibility regarding authorization for inpatient and outpatient levels of care.
  • Determine contract and benefit eligibility; Check benefits for facility based treatment.
  • Benefit eligibility and verification; maintains positive customer relations.
  • Determine contract and benefit eligibility.
  • Determine contract and program benefit eligibility as part of the outreach process.

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6 Benefit Eligibility Jobs

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10. Medical Records

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Here's how Medical Records is used in Account Management Representative jobs:
  • Delivered/received medical records to/from physician offices for patient appointments, archival, or other requests.
  • Submit Appeals for underpayment and requesting complete medical records for service not approved Retro Authorization.
  • Scanned medical records from other medical facilities into electronic files of patients.
  • Provided support to ensure accurate and timely completion of medical records.
  • Released new electronic medical records to other medical facilities.
  • Prepped charts and insured complete documentation of medical records.
  • Worked closely with admissions, billing, medical records, care management, and contracting to support appeals and communicating trends.
  • Utilized EpicCare EMR and SolCom databases for scanning records into the systems and searching and retrieving medical records.
  • Answer customer queries, complaints and problems on phone, Pulling Medical Records to appeal denials.
  • Processed and assembled medical records of discharged patients according to the prescribed record order format.
  • Performed chart audits via EMR, prepared medical records for subpoenas, general requests.
  • Assisted patients and families in the process of requesting medical records.
  • Assisted in satisfying all incoming requests for copies of medical records.
  • Assist customers and clients with retrieving and understanding medical records.
  • Assisted patients in acquiring their personal medical records.
  • Released paper medical records to patients.
  • Filed and retrieved medical records.
  • Complete applications for Federal programs, reviewing medical records and taking all necessary action to expedite benefit approval.
  • Maintained medical records for hospital patients and performed other clerical duties as required.
  • Scanned and indexed roughly 4,000 documents per month into patients electronic medical records.

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10 Medical Records Jobs

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11. Clinical Review

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high Demand
Here's how Clinical Review is used in Account Management Representative jobs:
  • Generated appropriate medical referral/prior authorizations not requiring clinical review to ensure timely and accurate claim adjudication.
  • Identify request that require clinical review by performing data entry to prepare cases for nurse reviewers.
  • Referred case for a clinical review, potential denial or modification of treatment parameters.
  • Analyzed, evaluated, & forwarded authorization requests for further clinical review.
  • Refer cases requiring clinical review to a Nurse reviewer.
  • Refer faxes containing clinical review to the Nurse reviewer.
  • Refered cases requiring clinical review to a nurse reviewer; handled referrsals for speciality care.

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6 Clinical Review Jobs

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12. Customer Relations

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high Demand
Here's how Customer Relations is used in Account Management Representative jobs:
  • Developed and maintained positive customer relations and coordinated with various functions within the company that ensured customer requests and questions.
  • Leverage polished interpersonal and communication skills to build and nurture strong customer relationships and ensure customer satisfaction.
  • Reached level two position with advancements in medical terminology education for better customer relations.
  • Developed and maintained positive customer relations and coordinated sessions with/ to the provider.
  • Develop and consistently maintain positive customer relations.
  • Enter call data in the relevant CRM (Customer Relationship Management) databases to assist case management reporting.
  • Maintain and enhance customer relations.
  • Developed and maintained positive customer relations and coordinated various functions to ensure customer requests were handled in a timely manner.
  • Developed and maintains positive customer relations and ensuring customer requests and questions are handled appropriately and in a timely manner.
  • Manage selective nationwide distributors to maintain a daily customer relationship and to up sale Panolam's decorative laminate material.
  • Developed and maintained positive customer relations appropriately in a timely manner.
  • Facilitated positive customer relations by managing their needs and issues for 97 regional accounts.
  • Repair Service Management Customer Relationship Management Financial Service Management

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13. In-House

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Here's how In-House is used in Account Management Representative jobs:
  • Worked with in-house departments to assist client in answering any question and getting the help they need.
  • Managed multiple screens, simultaneously, during intake while searching in-house database system for authorization requests.
  • Respond to telephone and written inquiries from clients, providers and in-house departments.
  • Validated and entered power and gas trades into an in-house deal entry system.
  • Act as the primary contact for in-house accounts customer orders.
  • Analyze problems and provides information/solutions Obtain and extract information; documents information, activities and changes in the in-house Medi-Care database.

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14. Outbound Calls

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high Demand
Here's how Outbound Calls is used in Account Management Representative jobs:
  • Handle all Inbound/Outbound calls to customers; fix agent, and technician in the United States, and International customer.
  • Contribute to the sales of GIV products through inbound and outbound calls from physician based customers.
  • Directed call traffic, made 100+ inbound/outbound calls, entered data, correspondence, etc.
  • Assist 40-60 customers daily about their U-verse accounts through inbound and outbound calls.
  • Managed incoming and outbound calls.
  • Provided exceptional customer service Handled inbound and outbound calls in high volume call center Assigned as team leader to increase productivity

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15. Outpatient Precertification

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Here's how Outpatient Precertification is used in Account Management Representative jobs:
  • Determined contract and benefit eligibility; provides authorization for inpatient admission and outpatient precertification and/or prior authorization requests.
  • Provided authorization for inpatient admission and outpatient precertification and/or prior authorization requests for surgical procedures or nuclear test.
  • Provide authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests.
  • Provide authorization for inpatient and outpatient precertification and prior authorization.

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5 Outpatient Precertification Jobs

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16. Nurse Reviewer

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6 Nurse Reviewer Jobs

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17. Initial Set

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Here's how Initial Set is used in Account Management Representative jobs:
  • Conducted clinical screening process and authorized initial set of sessions to provider.
  • Conducted clinical screening process, authorizing an initial set of sessions to the provider and checking benefits for facility-based treatment.
  • Authorize initial set of sessions to provider.

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4 Initial Set Jobs

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18. Plan Certificate

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Here's how Plan Certificate is used in Account Management Representative jobs:
  • Controlled the identification and data entry of referral requests into the UM system in accordance with the plan certificate.
  • Input referral request into the UM system in accordance with plan certificate.

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6 Plan Certificate Jobs

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19. Account Management

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Here's how Account Management is used in Account Management Representative jobs:
  • Account management - Providing total customer satisfaction with a positive attitude and excellent customer service.
  • Establish strong customer relations throughout account management process.
  • Specialized services for account management and records.
  • Acted as a liaison with sales department, account management and operations areas to ensure quality standards were met.
  • Account Management Representative Responsibilities: * Processed customer orders received via email, fax, and external customer systems.
  • Promoted to lead call escalated queue after seven months of working in the Account Management department.
  • Certificate as Account Management Contact Representative (Bilingual), by Internal Revenue Service.
  • Account management of all house accounts to maintain and build relationships and sales opportunities.
  • Promoted three times from a Customer Specialist up to Sr. Account Management Representative.
  • Provide account management of the sell of payroll tax data software.
  • Trained new account management representatives within the team and department.
  • Direct communication with clients, account management and marketing.
  • Answered inbound calls regarding credit card account management.
  • Assisted Tier 2 with account management.
  • Account Management Rep. Bankruptcy Chapter 7
  • Improved internal relationships by facilitating communications and account management for human resources operations while overseeing the benefits allocation for staff accounts.
  • Experience in complex methodologies of account management and analytical research.
  • Account Management * Design and manage company website utilizing expertise to update pricing and photographs.
  • Monitored and responded to Service Desk Account Management emails in a timely manner.
  • Provide account management services for employee benefits brokerage and consulting firm.

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3 Account Management Jobs

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20. Medical Services

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Here's how Medical Services is used in Account Management Representative jobs:
  • Authorize medical services utilizing non-clinical review as based on system protocols.
  • Serve as primary department support to Registered Nurse, staff members for Behavioral and Medical services.
  • Coordinated cases for precertification and prior authorization for medical services.

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21. CPT

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Here's how CPT is used in Account Management Representative jobs:
  • Trained and assisted hospital departments in requesting charge codes for new services and CPT/HCPCS updates.
  • Provided medical practitioners with Empire's reimbursement rates under CPT code guidelines.
  • Processed CPT/ICD-9 coding, refunds and supervised petty cash and deposits.
  • Processed ICD10 codes for patient diagnosis and CPT codes for billing.
  • Update fee schedules and specific CPT codes as needed.
  • research CPT andICD-9 codes for approval.
  • Review CPT codes and DIagnosis codes to ensure all codes are authorized by clinical staff while following ERISA timelines.
  • Verify if the patient CPT Code or ICD-9 code will require any precertification/preauthorization for the patient procedure.

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22. Customer Accounts

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Here's how Customer Accounts is used in Account Management Representative jobs:
  • Managed customer accounts-guided customers through complete order fulfillment cycle.
  • Manage and maintain numerous customer accounts to the full satisfaction of both the client and the company.
  • Maintained the customer accounts, patient's information also developed the forms and manuals.
  • Manage customer accounts via phone and email, order entry, problem resolution.
  • Manage customer accounts, from initial order placement to delivery.
  • Receive payments and post amounts paid to customer accounts.
  • Manage customer accounts and take payments working cash register.
  • Reviewed customer accounts, prior to installation dates.
  • Processed credits for customer accounts if needed.
  • Sell and Upgrade customer accounts Customer Service Dialer for outbound calls

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23. New Accounts

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Here's how New Accounts is used in Account Management Representative jobs:
  • Assisted customers with billing inquires as well as opening new accounts to help generate new revenue to company.
  • Secure referrals from existing employers and created new relationships with those employers for potential new accounts
  • Acquire new accounts by cold calling businesses, averaging four new customers per week.
  • Reset and distributed new accounts to newly employees at the USPTO.
  • Established new accounts and provide customer service.
  • Upgraded and created new accounts for worldwide Expedia customers.

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24. Internal Departments

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Here's how Internal Departments is used in Account Management Representative jobs:
  • Identified Client/Agent/Consultant key strategic issues and implemented solutions serving as a liaison between the Client and internal departments within the organization.
  • Documented demographic information in TriMed system and referred appropriate cases to internal departments.
  • Served as a liaison between Medical Management and internal departments, providing suggestions to streamline processes.
  • Coordinated with internal departments to ensure delivery of superior customer service and product to the account.
  • Respond to telephone or written inquiries, from members, providers, and internal departments.
  • Direct contacts with investors, banks, internal departments, and external companies.
  • Act as liaison between Medical Management and internal departments.
  • Collaborate with other internal departments to ensure accuracy of transactionsprocessed.

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25. Payment Arrangements

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Here's how Payment Arrangements is used in Account Management Representative jobs:
  • Re-negotiated secured payment arrangements including settlement arrangements.
  • Negotiated payment arrangements to bring account current and providing solutions to reducing delinquencies.
  • Negotiated payment arrangements, verified necessary information for referral and litigation processes.
  • Negotiated satisfactory payment arrangements and verification of pertinent account data.
  • Negotiate payment arrangements and settlement agreements.
  • Set up payment arrangements with customers.
  • Make outbound call to customers that are delinquent on CAF accounts Negotiate payment arrangements to bring accounts current.

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26. Medicaid

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Here's how Medicaid is used in Account Management Representative jobs:
  • Certified in many health-insurance programs and cross-trained in Medicare, Medicaid, ESI and UM (Utilization Management).
  • Ensured all documentation was accurately completed and in compliance with MEDICARE AND MEDICAID policy and Internal Audit standards.
  • Follow and comply with insurance guidelines for Medicaid, Medicare, Commercial, and Managed Care Accounts.
  • Assisted Medicare & Medicaid customers with portal access, ID cards, and summary of benefits statements.
  • Educate & enroll patients eligible for Medicaid to the Hospital Presumptive Eligibility (HPE) Medical Insurance.
  • Marketed managed care plans to clients on Medicaid and public assistance.
  • Completed Individual/Group healthcare provider enrollment applications to submit to Medicare and Medicaid also various insurance companies.
  • Interview Medicaid beneficiaries by telephone to determine eligibility for Federal disability benefits.
  • Generate Medicaid tracking reports to be used as a management tool to ensure that the districts maximize their Medicaid reimbursement.
  • Verified insurance coverage/benefits with insurance companies such as: Tricare, Blue Cross Blue Shield, Medicare and Medicaid.
  • Used Avaya Proactive Agent to reach out to new Members of Medicaid across several states.
  • Worked with UHC, Medicaid, Medicare, Tricare, Blue-Cross and Managed Care Insurances.
  • Direct manage care marketing to Medicaid clients of Erie County Dept of Social Services * Responsible for enrollment into program.

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27. Hipaa

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Here's how Hipaa is used in Account Management Representative jobs:
  • Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information.
  • Verified benefits and eligibility in accordance with HIPAA guidelines.
  • Assisted in the orientation and training of new hires, including HIPAA protocols.
  • Implemented an e-Fax system to maintain HIPAA compliance and documentation retention.
  • Prepare and send outgoing mail and being sure HIPAA compliant.
  • Worked in compliance to HIPAA, and company/federal guidelines.
  • Followed and implemented all PHI and HIPAA guidelines.
  • Maintain privacy guidelines as required per HIPAA.
  • Follow guidelines from JCAHO and HIPAA Knowledge of Epic Hyperspace.

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4 Hipaa Jobs

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28. Medical Management

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Here's how Medical Management is used in Account Management Representative jobs:
  • Contracted medical support personnel under Medical Management (Utilization Review) for the National Accounts / NY Core Division.
  • Contracted thru WellPoint BlueCross BlueShield to facilitate Healthy NY, Child Health Plus and Medical Management.

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29. Hippa

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Here's how Hippa is used in Account Management Representative jobs:
  • Retrieved incomplete record for physician completion * Provided medical information patient care providers according to HIPPA.
  • Reviewed reports and transcripts for accuracy and distributed within HIPPA regulations.
  • Maintained critical confidentiality per HIPPA guidelines.
  • Verified identity of persons requesting information and made sure that the necessary forms and documentation were correct according to HIPPA standards.
  • Supported transcript services by receiving all transcribed reports, ensuring accuracy, copying and distributing within HIPPA policy.
  • Trained medical staff and hospital administrators on completion of health insurance claim forms and HIPPA regulations.
  • Train all new and current employees on all work processes including HIPPA policy and regulations.
  • Verify HIPPA, on every call, and resolve issues on first call.
  • Ensured patient confidentiality was in compliance with hospital policy and HIPPA law.
  • Maintain confidentiality with clients records and files according to HIPPA guidelines and restrictions
  • Adhere to HIPPA guidelines, confidentiality and company compliance
  • Applied HIPPA to every call.
  • Honored HIPPA rules and regulations.

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30. High Volume

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Here's how High Volume is used in Account Management Representative jobs:
  • Entered high volume of utility payments into proprietary accounts payable software
  • Answered a high volume of customer inquiries via telephone regarding services applications, rates, programs, billing, credit.
  • Provided timely, accurate, and courteous responses to a high volume of telephone inquiries from both members and providers.
  • Group leader selected as troubleshooter to resolve out standings on high dollar/high volume accounts.
  • Answered a high volume of incoming calls inquiries from clients and colleagues.
  • Processed high volume of calls, both escalated and general inquiries.
  • Answered high volume inbound calls within a call center environment.
  • Call Center High Volume Environment Educate members on their medical coverage and eligibility Describe what you did, accomplished, or learned

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31. Durable Medical Equipment

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Here's how Durable Medical Equipment is used in Account Management Representative jobs:
  • Managed prior authorizations for approval/denial of durable medical equipment for subscribed Medicare patients.

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32. Patient Care

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Here's how Patient Care is used in Account Management Representative jobs:
  • Provide medical information to patient care providers according to established guidelines.
  • Communicate with insurance carriers; adjuster to better accommodate patient care.
  • Review Reports of patient care gaps to identify HEDIS gaps.
  • Empowered to make decisions that improve patient care.
  • Full knowledge of patient care form a patient finical aspect.

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1 Patient Care Jobs

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33. Delinquent Accounts

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Here's how Delinquent Accounts is used in Account Management Representative jobs:
  • Conducted aging review of clients or business centers assigned by Collection Manager to identify delinquent accounts.
  • Located and notified customers of delinquent accounts, soliciting payments and providing exceptional customer service.
  • Conducted Outbound Collection calls to Businesses involving delinquent accounts.
  • Negotiate payment arrangements for delinquent accounts.
  • Contacted and collected delinquent accounts.
  • Managed collection efforts of over 2000+ accounts and contact account holders in an effort to resolve billing discrepancies and delinquent accounts.
  • Ensured that all collection efforts ceased on delinquent accounts that were placed into bankruptcy and referred to the specialty legal.
  • Reviewed and analyzed details of delinquent accounts to become familiar with client situation.
  • Manage delinquent accounts in order to retain subscribers and collect monies owed
  • Maintain a corporate customer list of monthly delinquent accounts.
  • Assisted with settling delinquent accounts with Farmers Milk.
  • Maintained accounts for the collections department, on 3 to 6 months delinquent accounts.
  • Assist customers with delinquent accounts Negotiate payment arrangements Answer inbound calls, and assist new employees in training
  • Utilize PC to collect on past due accounts Customer service Incoming calls Assist customers with options on delinquent accounts

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34. Specialty Care

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Here's how Specialty Care is used in Account Management Representative jobs:
  • Referred cases requiring clinical review to a nurse reviewer, and handled referrals for specialty care.

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35. Special Projects

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Here's how Special Projects is used in Account Management Representative jobs:
  • Assisted in the management of large accounts, including implementation, reviews, customer service, reports and special projects.
  • Followed up on all claims, including receivables workstation, monthly follow-up reports, and customer service work/special projects.
  • Handled special projects, helped my fellow co workers with orders and issues as a team lead.
  • Assigned to special projects focusing on specific insurance payers and worker's compensation cases.
  • Created and responsible for weekly reports, associated tasks and special projects.
  • Assist Billing Supervisor with special projects and various other duties as assigned.
  • Assist with special projects including back end and front end edits.
  • Assisted with accounts receivable & special projects
  • Worked special projects as needed.
  • Handled various positions over the years to support THC Group special projects, among others was being a Quality Mgt.
  • Assist with special projects and state-wide RMTS trainings and in-services for HISD and client districts.

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36. Patient Accounts

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Here's how Patient Accounts is used in Account Management Representative jobs:
  • Investigated delinquent commercial accounts, audits f patient accounts on receivables, negotiated/prompt payments/discount rates.
  • Identified patient accounts for collections action when accounts become delinquent or when unable to contact patient or responsible party.
  • Analyzed and discussed disputed patient accounts with senior management to satisfy patient's distresses.
  • Apply Medicare, Medicaid HMO/PPO adjustments to patient accounts per contracts.
  • Reviewed patient accounts to identify error trends.
  • Credit and charged items to patient accounts.

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37. Patient Demographics

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38. Medical Necessity

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Here's how Medical Necessity is used in Account Management Representative jobs:
  • Processed clinical information for review to meet medical necessity for inpatient or outpatient services per insurance guidelines.
  • Authorized specifically designated services, based on company policy, which did not require medical necessity review.
  • Determined medical necessity with clinical skills and judgment to determine action needed based on established criteria.
  • Exercise independent judgment in reference to assessing the medical necessity for authorization of routine outpatient services.
  • Explained medical necessity criteria based on denials of authorizations for behavioral health services.
  • Certify surgical procedures through communication with insurance companies to determine medical necessity.
  • Worked with hospital departments to reduce Medicare medical necessity write-offs.
  • Analyzed and trending Medicare outpatient medical necessity write-offs.

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39. Computer System

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Here's how Computer System is used in Account Management Representative jobs:
  • Interact efficiently with comprehensive computer system with extensive customer base.
  • Processed customers' payment via inter-company computer system.
  • Navigated through many computer systems simultaneously.
  • Used specialized computer system daily.
  • Performed routine clerical tasks using telephone, fax, computer systems and other general office equipment.
  • Prepared and controlled the budget, paid bills, accounts and general computer systems supervisor.
  • Updated information on the computer system in order to permit claims to be processed.
  • Verified that information in the computer system was up-to-date and accurate.
  • Used window based computer system, including Microsoft Word and Excel.
  • Set up new computer systems and electronic claims submission.
  • Receive consecutive phone calls, accurately enter data into the computer system in a timely manner.
  • Provided IT support for over 500 computer systems while in deployed in Iraq and Kuwait.
  • Maintain detailed documentation of client contacts and application status in Change Healthcare computer systems and web-based applications.
  • Update and manage spreadsheets using MS Excel Daily use of computer system, programs and applications.
  • Maintain documentation of status of claims and client contact on Chamberlin Edmonds computer system.
  • Answer calls for prior authorization (150 plus calls a day) Input data into computer system Review pre-existing for prior authorizations

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40. Medical Procedures

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low Demand
Here's how Medical Procedures is used in Account Management Representative jobs:
  • Experience in intake of clinical information of ICD 9/10 codes and approved or declined of major medical procedures to be insured.
  • Authorized in and out patient medical procedures for plan members.
  • Worked in medical care management field verifying pre-authorization requirements for medical procedures based on health plan requirements.
  • Receive inbound calls and advise members of pre-certification requirements for upcoming medical procedures
  • Handled requests for medical procedures and medications that required pre-certification.
  • Create cases for medical procedures that require pre-authorization.
  • Authorized diagnostic scans, injectable pain medications, bariatric surgeries, extended maternity stays, and various medical procedures.
  • Prepared and forwarded requests for certain major medical procedures to onsite to MDs.

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41. HMO

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Here's how HMO is used in Account Management Representative jobs:
  • Processed medical PPO, HMO, and workers compensation claims, providing follow-up for a third party administrator.
  • Received 2011 Team Contributor Beyond and Above Award/ 2009 Mount Rushmore Recipient for #1 ranked sales team.
  • Utilized in-depth contacts for the market of HMO services to a targeted client base.
  • Worked all managed care: MIDPA, Alliance, GEHA, PruCare & Kaiser HMO.
  • Developed first ever joint sales visual for Humana HMO.

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42. External Customers

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Here's how External Customers is used in Account Management Representative jobs:
  • Provided information to internal/external customers using appropriate knowledge and communication skills.
  • Worked closely with external customers toward the timely execution of contracts.
  • Educated staff, patients, and external customers by promoting and developing workshops and seminars on managed care topics.
  • Achieved a 90% score on both verbal and written communication skills to all internal and external customers.
  • Received and handle telephone inquiries regarding OTR status and general OTR questions from internal & external customers.
  • Present a cooperative and helpful attitude at all times to internal and external customers and co-workers.
  • Provided accurate reports to internal and external customers in a timely manner.

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43. EOB

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Here's how EOB is used in Account Management Representative jobs:
  • Review of Explanation of Benefits (EOB), contract interpretation, appeals submission, retroactive authorization requests and accounts adjustment.
  • Review all participating payment EOB's to ensure proper allowance.
  • Received and worked correspondence and EOB's.
  • explained Explanation of Benefits (EOB) to patients and assist with various billing questions and updating demographic information.
  • Review all EOBs received on a daily basis it insure accuracy of payment by various carriers.

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44. Technical Support

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Here's how Technical Support is used in Account Management Representative jobs:
  • Assisted the floor manager with the day to day data entry of agents and technical support.
  • Provided 2nd level technical support for Tier 2 Ticket Management Team.
  • Work with Sales, Credit and Technical Support teams to ensure service contracts are renewed, billed and implemented consistently.
  • Order handling, processing, and aiding technicians with receiver and computer modem swapping and technical support.

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45. Outpatient Clinic

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Here's how Outpatient Clinic is used in Account Management Representative jobs:
  • Covered registration clerks when short staffed for both outpatient clinics.

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46. Sound Judgment

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Here's how Sound Judgment is used in Account Management Representative jobs:
  • Elicit sensitive, personal and financial information and makes determinations by using sound judgment concerning controversial matters.
  • Make determinations and uses sound judgment concerning controversial matters in reporting the degree to which the individual understood their responsibilities.
  • Make determinations and use sound judgment to resolve taxpayer disputes and delinquency issues.
  • Demonstrated sound judgment in dealing with associates in other departments while resolving issues.

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47. Health Care

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Here's how Health Care is used in Account Management Representative jobs:
  • Coordinate services/health care services by facilitating, scheduling, and arranging a variety of treatment and services.
  • Provided technical support for Health Care Professionals accessing the New York State Health Commerce System website.
  • Provided Behavioral health care communications counseling, using both inbound and outbound process.
  • Educate customers and providers on Anthem's health care management policies and procedures.
  • Provide health care plan members and providers mental health benefits and authorization information.
  • Refer patients to appropriate health care services or resources.
  • Contracted and recruited new Health Care Organizations.
  • Achieve patient interviews and health care education.

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48. Customer Complaints

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Here's how Customer Complaints is used in Account Management Representative jobs:
  • Respond to average calls per day and resolve customer complaints or concerns with positive attitude.
  • Write up new part quotations and customer complaints * Assist sales staff, CEO, and President.

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49. Customer Questions

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low Demand
Here's how Customer Questions is used in Account Management Representative jobs:
  • Communicate effectively with upper management and Sales management to convey customer questions or concerns.
  • Work with other departments/personnel where necessary to resolve customer questions/issues.
  • Answered customer questions regarding deductibles.
  • Assisted Customer Care Representatives within the department with customer questions, issues and or request.
  • Answer phones respond to all customer questions, inquiries and problems.
  • Resolved customer questions, issues and complaints.

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50. Powerpoint

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low Demand
Here's how Powerpoint is used in Account Management Representative jobs:
  • Created PowerPoint presentations for daily operations.
  • Developed skills such as multitasking, and knowledge of MS Word, Excel, Access, Outlook, and PowerPoint.

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Account Management Representative Jobs

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20 Most Common Skills For An Account Management Representative

Customer Service

14.0%

Provider Finder

12.0%

Data Entry

6.7%

Phone Calls

6.7%

Authorization Review

4.9%

Financial Statements

4.8%

Inpatient Admissions

4.3%

Insurance Companies

4.3%

Benefit Eligibility

4.2%

Medical Records

4.2%

Clinical Review

4.1%

Customer Relations

3.8%

In-House

3.7%

Outbound Calls

3.7%

Outpatient Precertification

3.5%

Nurse Reviewer

3.3%

Initial Set

3.2%

Plan Certificate

3.2%

Account Management

3.1%

Medical Services

2.2%
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Typical Skill-Sets Required For An Account Management Representative

Rank Skill
1 Customer Service 10.5%
2 Provider Finder 9.0%
3 Data Entry 5.0%
4 Phone Calls 5.0%
5 Authorization Review 3.7%
6 Financial Statements 3.6%
7 Inpatient Admissions 3.2%
8 Insurance Companies 3.2%
9 Benefit Eligibility 3.2%
10 Medical Records 3.2%
11 Clinical Review 3.1%
12 Customer Relations 2.8%
13 In-House 2.8%
14 Outbound Calls 2.8%
15 Outpatient Precertification 2.6%
16 Nurse Reviewer 2.5%
17 Initial Set 2.4%
18 Plan Certificate 2.4%
19 Account Management 2.3%
20 Medical Services 1.7%
21 CPT 1.6%
22 Customer Accounts 1.6%
23 New Accounts 1.5%
24 Internal Departments 1.4%
25 Payment Arrangements 1.4%
26 Medicaid 1.3%
27 Hipaa 1.2%
28 Medical Management 1.2%
29 Hippa 1.0%
30 High Volume 1.0%
31 Durable Medical Equipment 1.0%
32 Patient Care 0.9%
33 Delinquent Accounts 0.8%
34 Specialty Care 0.8%
35 Special Projects 0.8%
36 Patient Accounts 0.7%
37 Patient Demographics 0.7%
38 Medical Necessity 0.6%
39 Computer System 0.6%
40 Medical Procedures 0.6%
41 HMO 0.5%
42 External Customers 0.5%
43 EOB 0.4%
44 Technical Support 0.4%
45 Outpatient Clinic 0.4%
46 Sound Judgment 0.4%
47 Health Care 0.4%
48 Customer Complaints 0.4%
49 Customer Questions 0.4%
50 Powerpoint 0.4%
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