Strategic Managed Care Billing & Collections Specialist

Saint Clare's Health; Denville (NJ); On-site; USD 22,000 - 37,000; Full time

Job summary

Prime Healthcare is seeking a Billing Specialist to lead the timely follow-up of Managed Care and Commercial accounts. The role requires clear phone communication with health plans, adherence to productivity standards, and knowledge of state collection guidelines where applicable.

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

Qualifications

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

Responsibilities

• Billing Specialist 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.

Skills

Managed care experience

Contract interpretation

Hospital billing knowledge

Education

Bachelor's degree or equivalent work experience

Job description

Prime Healthcare is seeking a Billing Specialist to lead the timely follow-up of Managed Care and Commercial accounts. The role requires clear phone communication with health plans, adherence to productivity standards, and knowledge of state collection guidelines where applicable.

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