Managed Care Account Specialist

2 weeks ago


Denville New Jersey, United States Prime Healthcare Management Inc Full time

Overview:
Prime Healthcare Management Inc. is a prestigious healthcare organization based in Ontario, California.

With a network of 45 hospitals and over 300 outpatient facilities across 14 states, we facilitate more than 2.6 million patient interactions each year.

As one of the leading health systems in the nation, we employ nearly 50,000 dedicated professionals and physicians. Fourteen of our hospitals are affiliated with the Prime Healthcare Foundation, a recognized 501(c)(3) not-for-profit public charity. We are currently seeking new talent to enhance our corporate team.

Prime Healthcare Management Inc. is an equal opportunity employer.

We strictly prohibit discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (where applicable), disability, military status, genetic information, or any other characteristic protected by federal, state, or local laws.

Additionally, we do not tolerate harassment of applicants or employees based on any of these protected categories.

Know Your Rights:

Responsibilities:
The Managed Care Account Specialist will take the lead in ensuring timely follow-up on Managed Care and Commercial accounts. This role requires clear and efficient communication with health plans via phone. The Specialist will maintain productivity standards and generate reports. It is essential to acquire State collection guidelines when necessary and to review managed care contracts thoroughly.

Qualifications:
EDUCATION, EXPERIENCE, TRAINING

  • A minimum of four years of experience in hospital managed care or commercial collections is required.
  • A Bachelor's degree or equivalent professional experience is preferred.
  • Proficiency in contract interpretation is essential.
  • Familiarity with hospital billing requirements is necessary.


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