Account Resolution Specialist - Managed Care Collections

Centinela Hospital Medical Center; Denville (NJ); On-site; USD 23,000 - 38,000; Full time

Benefits offered by this job

401K retirement plan

Medical, dental, and vision coverage

Tuition reimbursement

Paid time off

Job summary

Prime Healthcare Management Inc is seeking a Specialist, Account Resolution to lead timely follow-up of Managed Care/Commercial accounts and to communicate with health plans by phone. The role includes maintaining productivity and reporting, and reviewing state collection guidelines where applicable.

Key qualifications include four years of hospital managed care experience, a bachelor’s degree or equivalent, and knowledge of contract interpretation, plus familiarity with hospital billing

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

• Lead responsible for the timely follow-up of Managed Care/Commercial accounts; communicates 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

Phone communication

Contract interpretation

Hospital billing

Education

Bachelor’s degree or equivalent

Job description

Prime Healthcare Management Inc is seeking a Specialist, Account Resolution to lead timely follow-up of Managed Care/Commercial accounts and to communicate with health plans by phone. The role includes maintaining productivity and reporting, and reviewing state collection guidelines where applicable.

Key qualifications include four years of hospital managed care experience, a bachelor’s degree or equivalent, and knowledge of contract interpretation, plus familiarity with hospital billing