Managed Care Collections & Account Resolution Specialist

Kardow; Lynwood (CA); On-site; USD 32,000 - 39,000; Full time

Job summary

Prime Healthcare in Ontario, California, is seeking a Specialist, Account Resolution to lead timely follow-up of Managed Care/Commercial accounts and to communicate by phone with health plans, while maintaining productivity and reporting on progress.

Qualifications include a minimum of four years in hospital managed care/commercial collections, a bachelor’s degree or equivalent work experience, and knowledge of contract interpretation with familiarity in hospital billing requirements.

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 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.

Education

Bachelor’s degree or equivalent work experience

Job description

Prime Healthcare in Ontario, California, is seeking a Specialist, Account Resolution to lead timely follow-up of Managed Care/Commercial accounts and to communicate by phone with health plans, while maintaining productivity and reporting on progress.

Qualifications include a minimum of four years in hospital managed care/commercial collections, a bachelor’s degree or equivalent work experience, and knowledge of contract interpretation with familiarity in hospital billing requirements.