Managed Care Account Resolution Specialist

St. Francis Medical Center; Lynwood (CA); On-site; USD 32,000 - 39,000; Full time

Job summary

Prime Healthcare is seeking a Specialist, Account Resolution to lead timely follow-up on Managed Care/Commercial accounts. You will communicate with health plans by phone, maintain productivity, and report on status. You may obtain State collection guidelines where applicable and review managed care contracts.

The role demands several years in hospital managed care collection, contract interpretation, and hospital billing familiarity, with a full-time schedule in California.

Qualifications

• Minimum of four years hospital managed care/commercial collector experience.
• Knowledge of contract interpretation.
• Familiar with hospital billing requirements.

Responsibilities

• 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.

Education

Bachelor's degree or equivalent work experience

Job description

Prime Healthcare is seeking a Specialist, Account Resolution to lead timely follow-up on Managed Care/Commercial accounts. You will communicate with health plans by phone, maintain productivity, and report on status. You may obtain State collection guidelines where applicable and review managed care contracts.

The role demands several years in hospital managed care collection, contract interpretation, and hospital billing familiarity, with a full-time schedule in California.