Account Resolution Specialist

Prime Healthcare; Garden City (MI); On-site; USD 42,000 - 65,000; Full time

Job summary

Prime Healthcare is seeking a Specialist, Account Resolution to lead timely follow-up of Managed Care/Commercial accounts. You will communicate by phone with health plans, maintain productivity, and ensure compliance with state guidelines when applicable.

The role requires four years of hospital managed care experience and a Bachelor’s degree or equivalent; knowledge of contract interpretation and hospital billing is essential.

Qualifications

• Minimum of four years hospital managed care/commercial collector experience.
• Bachelor’s degree or equivalent work experience preferred.
• Knowledge of contract interpretation and hospital billing requirements.

Responsibilities

• Lead responsible for timely follow-up of Managed Care/Commercial accounts.
• Communicates clearly by phone with health plans.
• Maintains productivity standards and reports.
• Responsible to obtain State collection guidelines if applicable.
• Reviews managed care contracts.

Skills

Managed care experience

Contract interpretation

Phone communications with health plans

Education

Bachelor’s degree or equivalent

Job description

Overview

Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

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Responsibilities

The Specialist, Account Resolution is the lead responsible for the timely follow-up of Managed Care/Commercial accounts. Communicates clearly and efficiently by phone with health plans. Maintains productivity standards and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts.

Qualifications

1. Minimum of four years hospital managed care/commercial collector experience required.

2. Bachelor’s degree or equivalent work experience preferred

3. Knowledge of contract interpretation

4. Familiar with hospital billing requirements

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf