Account Resolution Specialist
Prime Healthcare, Kansas City, MO, United States
Account Resolution Specialist
We are seeking an Account Resolution Specialist, sometimes referred to as a Managed Care Follow-Up Specialist or Commercial Account Follow-Up Specialist. The Account Resolution Specialist is responsible for the timely follow-up and resolution of Managed Care and Commercial accounts, ensuring accurate reimbursement and compliance with payer and state collection guidelines. This role communicates clearly and professionally with health plans by phone, reviews managed care contracts and maintains required productivity standards and reporting. Shifts Available: Days Employment Type: Full-time Primary Focus: Medicare Billing and Follow-up Hours: 8-hour shift Location: St Joseph Medical Center
Kansas City, MO Here are some of the benefits of working at Prime Healthcare: Health, dental, and vision insurance options Paid vacation, sick time and holidays Bereavement leave, FMLA and other leave options Employer 401K options Tuition reimbursement options Life, disability, and other insurance options Many other amazing benefits Responsibilities
Essential Duties and Responsibilities (includes, but not limited to): Perform timely follow-up on Managed Care and Commercial accounts to support accurate reimbursement and account resolution Communicate clearly and efficiently with health plans by phone regarding account status, payment issues, and follow-up needs Review managed care contracts to ensure reimbursement aligns with contractual terms and requirements Obtain and apply state collection guidelines, when applicable, to support compliant account resolution practices Maintain productivity standards and complete required reports accurately and on time Qualifications
Before we go any further, we do have some deal-breakers. You must have: Minimum of four years hospital managed care/commercial collector experience required Additional Required Knowledge, Skills & Abilities: Knowledge of contract interpretation Familiar with hospital billing requirements Additional Qualifications That Are a Plus: Bachelor's degree or equivalent work experience preferred Equal Employment Opportunity
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
We are seeking an Account Resolution Specialist, sometimes referred to as a Managed Care Follow-Up Specialist or Commercial Account Follow-Up Specialist. The Account Resolution Specialist is responsible for the timely follow-up and resolution of Managed Care and Commercial accounts, ensuring accurate reimbursement and compliance with payer and state collection guidelines. This role communicates clearly and professionally with health plans by phone, reviews managed care contracts and maintains required productivity standards and reporting. Shifts Available: Days Employment Type: Full-time Primary Focus: Medicare Billing and Follow-up Hours: 8-hour shift Location: St Joseph Medical Center
Kansas City, MO Here are some of the benefits of working at Prime Healthcare: Health, dental, and vision insurance options Paid vacation, sick time and holidays Bereavement leave, FMLA and other leave options Employer 401K options Tuition reimbursement options Life, disability, and other insurance options Many other amazing benefits Responsibilities
Essential Duties and Responsibilities (includes, but not limited to): Perform timely follow-up on Managed Care and Commercial accounts to support accurate reimbursement and account resolution Communicate clearly and efficiently with health plans by phone regarding account status, payment issues, and follow-up needs Review managed care contracts to ensure reimbursement aligns with contractual terms and requirements Obtain and apply state collection guidelines, when applicable, to support compliant account resolution practices Maintain productivity standards and complete required reports accurately and on time Qualifications
Before we go any further, we do have some deal-breakers. You must have: Minimum of four years hospital managed care/commercial collector experience required Additional Required Knowledge, Skills & Abilities: Knowledge of contract interpretation Familiar with hospital billing requirements Additional Qualifications That Are a Plus: Bachelor's degree or equivalent work experience preferred Equal Employment Opportunity
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf