Account Resolution Specialist

Prime Healthcare; Garden City (MI); On-site; USD 42,000 - 56,000; Full time

Job summary

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

The role requires at least four years of hospital managed care/commercial collection experience and a solid understanding of contract interpretation and hospital billing requirements. Full-time, daytime shift.

Qualifications

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

Responsibilities

• The Specialist, Account Resolution leads timely follow-up of Managed Care/Commercial accounts and communicates with health plans by phone.
• Maintains productivity standards and reports outcomes.
• Obtains state collection guidelines if applicable and reviews managed care contracts.

Skills

Managed care experience

Billing knowledge

Contract interpretation

Hospital operations

Education

Bachelor's degree or equivalent

Job description

Overview

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Garden City Hospital, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

At Garden City Hospital, we pride ourselves on community involvement and commitment to preserving access to quality and compassionate healthcare. We are a state-of-the-art medical facility with over 300 licensed beds and a teaching hospital, offering medical education to students, residents and fellows from across the country. The residency and fellowship programs offer graduate medical education to more than 80 trainees in specialties. Garden City Hospital has an award-winning staff of over 350 of the area's best and brightest physicians from almost every specialty. Learn more at www.gch.org.

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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