Managed Care Account Resolution Specialist

Prime Healthcare; Denville (NJ); On-site; USD 23,000 - 39,000; Full time

Job summary

Prime Healthcare in the United States seeks a Specialist, Account Resolution to lead timely follow-up of managed care and commercial accounts by phone with health plans, ensuring productivity and compliance with guidelines. Responsibilities include reviewing contracts and applying hospital billing knowledge.

The role requires at least four years in hospital managed care collecting, with a bachelor’s degree or equivalent preferred. Full-time, days, on-site position in New Jersey.

Qualifications

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

Responsibilities

• Lead the timely follow-up of managed care/commercial accounts by phone with health plans.
• Maintain productivity standards and report on progress.
• Obtain state collection guidelines where applicable and review contracts.

Skills

Managed care experience

Contract interpretation

Hospital billing knowledge

Education

Bachelor's degree or equivalent

Job description

Prime Healthcare in the United States seeks a Specialist, Account Resolution to lead timely follow-up of managed care and commercial accounts by phone with health plans, ensuring productivity and compliance with guidelines. Responsibilities include reviewing contracts and applying hospital billing knowledge.

The role requires at least four years in hospital managed care collecting, with a bachelor’s degree or equivalent preferred. Full-time, days, on-site position in New Jersey.