Account Resolution Specialist

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
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

Education and Work Experience
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
Employment Status

Full Time
Shift

Days
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