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Billing Operations Lead

2 months ago

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

Job Summary:

The Billing Specialist will be responsible for leading the timely follow-up of Managed Care/Commercial accounts. This role will communicate clearly and efficiently by phone with health plans, maintain productivity standards, and report on progress. The Specialist will also be responsible for obtaining State collection guidelines if applicable and reviewing managed care contracts.

Responsibilities:

  • Lead the follow-up of Managed Care/Commercial accounts to ensure timely resolution of billing issues
  • Communicate clearly and efficiently by phone with health plans to resolve billing discrepancies
  • Maintain productivity standards and report on progress to management
  • Obtain State collection guidelines if applicable to ensure compliance with regulations
  • Review managed care contracts to ensure compliance with terms and conditions

Qualifications:

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