Prime Healthcare Servicesposted 4 months ago
Full-time - Mid Level
Garden City, MI
251-500 employees
Ambulatory Health Care Services

About the position

The Specialist, Account Resolution plays a crucial role in managing and resolving accounts related to Managed Care and Commercial insurance. This position is responsible for ensuring timely follow-up on accounts, effective communication with health plans, and adherence to productivity standards. The role also involves reviewing managed care contracts and obtaining state collection guidelines when necessary.

Responsibilities

  • Lead the timely follow-up of Managed Care/Commercial accounts.
  • Communicate clearly and efficiently by phone with health plans.
  • Maintain productivity standards and reports.
  • Obtain State collection guidelines if applicable.
  • Review managed care contracts.

Requirements

  • 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.
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