Account Representative - Exceptions - PRISM (IRR)

March 3, 2010

Major Job Responsibilities

May include one or more of the following, depending on assigned area:

1. Serve as Customer Service Representative for assigned accounts on day-to-day basis by: 
   • Receive and respond to clients' requests and inquiries. Collaborate with Account Team, Operations Managers, Business Development Manager, IT, and Product Marketing when necessary, to facilitate action needed to meet a Client's request.  
   • Establish strong rapport and relationships with Client contacts to facilitate communications and help ensure Client satisfaction. 
   • Provide customized analytical reports using MS excel and Report Writer. 
   • Lead client conference calls. Prepare and distribute agenda and follow-up documentation within 24 hours of the call. 
2. Management of weekly process within specified deadlines for Client accounts:
   • Coordination of claims and payor data tape processing with system administration. 
   • Coordination and supervision of manual payor remittance processing by Mexico for assigned Clients.
   • Complete claims processing within 24 hours of receipt of files.
   • Work with Account Analyst to review store volume and pre-process reporting and implement corrective action as appropriate. 
   • Delivery of Point of Sale (POS) and claims exceptions within 24 hours of posting claims.
   • Complete write-offs and reclassifications weekly according to the Client's processing guidelines. Obtain prior authorization from Client for adjustments that are not part of the weekly process. 
   • Perform check batch association and reviews balancing transactions.
   • Complete manual application-association of header checks against remittance detail by end of business week received. 
   • Review remittance received from Mexico and determine appropriate course of action to reduce clients' receivable. 
   • Provide weekly/periodic reporting to Clients in accordance with Client's accounting calendar, initiate Save to Update weekly performance measurements document by end of week of occurrence. 
   • Establish and maintain processing guidelines booklet for each Client (including special write-off or re-class procedures, manual billing procedures, reporting schedule, etc.) to be used by back-up Account Representative as a resource for processing when the assigned Representative is out of the office. 
3. Identification and resolution of processing problems: 
   • Work with Client and data provider to identify and resolve claim file issues including but not limited to, missing or incorrect stores or plans. 
   • Work with Clients, payors, and bank to identify and resolve payment issues including but not limited to, missing checks or deposits. 
   • Identify and resolve unapplied header checks within specified aging parameters for Client accounts. Notify Manager of status for those outside the acceptable parameters. 
   • Work with payors and Clients to identify and resolve remittance issues including but not limited to, missing pages of detail or missing or unreadable tapes. 
   • Assist Account Analyst on special processing tasks required to meet client accounting needs.  
   • Communicate appropriate issues to Account Team, Operations Manager and Business Development Manager. 
   • Makes recommendations for system enhancements or process changes in response to workflow, data, or processing issues. 
4. Master File Maintenance:
   • Ensures integrity of all Master Files by performing on-going database management of the Client Master, Payor Master, Adjustment Code Files and others as required. 
5. Participate on conversion team as assigned by team leader:
   • Perform both payor and Client conversion activities as assigned by the Client team leader. Includes but is not limited to, master file set-up, systems testing, and analysis of data. 
6. Performs special projects as assigned by the team leader and cross trains new team members as assigned.

QUALIFICATIONS:

Required Ability To 

• analyze internal transaction settlement business operations and  make appropriate recommendations
• handle controversial matters in a diplomatic manner
• prepare complex and proceduralized financial reports and records
• professionally handle angry or frustrated clients to maintain good business relations
• compose routine and professional correspondence and reports 
• provide cross training to coworkers
• work efficiently and accurately in an atmosphere of frequent interruption
• work effectively in a dynamic environment with constantly changing priorities and stringent deadlines
• proceed independently and carry out assignments to completion with minimal instruction
• accurately perform alpha/numeric data entry 
• 10-key by touch 
• perform detailed work with numerical data rapidly and accurately  to make mathematical computation rapidly and accurately 
• analyze transactions, detect and correct errors
• explain Company products and services to Clients by telephone 
• speak in a clear, understandable way
• provide clear, explicit instructions
• travel independently

Required Knowledge of

• intermediate level of proficiency using MS Excel and Word
• AS400 Systems—preferred 
• proper use of spoken English language
• problem analysis
• basic English composition
• general office practices and procedures

Required Personal Characteristics  

• excellent customer service skills
• pleasant "telephone" voice
• time management and organizational skills to ensure completion of all tasks within assigned deadlines
• courteous, helpful
• math aptitude
• detail oriented
• analytical aptitude
• good grammar
• self-motivated
• comfortable working under consistent deadline pressure
• comfortable working independently and maintaining multiple responsibilities
• cooperative in maintaining working relationships with those contacted in performance of duties
• adaptability to change
• discrete, honest, tactful
• comfortable working in a team environment
• grooming and dress appropriate for office environment
• professional manner
• reliability, regular attendance at work

EDUCATION, TRAINING, EXPERIENCE

The above skills are typically acquired through:

• At least four years of relevant experience involving customer service, computer usage, data entry and data analysis AND a B.S. degree in Business Administration, Accounting, or related field; 
• OR an equivalent combination of training and experience.