Managed Care Account Specialist

2 weeks ago


Las Vegas, Nevada, United States North Vista Hospital Full time

Position Overview:

At North Vista Hospital, we pride ourselves on our unwavering commitment to quality, compassion, and community. As part of Prime Healthcare, recognized as a Top-15 hospital system in the United States, we are eager to welcome new professionals to our esteemed team.

North Vista Hospital is a fully accredited 177-bed facility situated in North Las Vegas, Nevada. We provide a wide array of healthcare services, including mental health support, emergency services, cardiac care, advanced surgical interventions, diagnostic imaging, and assistance for various medical conditions. Our hospital is equipped with cutting-edge medical technology and staffed by a team of highly trained healthcare professionals dedicated to delivering exceptional care in a welcoming environment. We have received numerous accolades for our quality of care, including the Patient Safety Excellence Award, Bariatric Surgery Excellence Award, and Heart Failure recognition, among others.

Equal Employment Opportunity:
North Vista Hospital is an equal opportunity employer. We prohibit discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (as permitted by law), disability, military status, genetic information, or any other protected category under applicable federal, state, or local laws. Harassment based on these protected categories is also strictly prohibited.

Key Responsibilities:
The Account Resolution Specialist will be primarily responsible for the prompt follow-up of Managed Care and Commercial accounts. This role involves clear and efficient communication with health plans via phone. The specialist is expected to maintain productivity standards and generate reports as necessary. Additionally, the role requires obtaining state collection guidelines when applicable and reviewing managed care contracts.

Qualifications:
Education and Experience:

  1. A minimum of four years of experience in hospital managed care or commercial collections is required.
  2. A bachelor's degree or equivalent work experience is preferred.
  3. Proficiency in contract interpretation is essential.
  4. Familiarity with hospital billing requirements is necessary.


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