JOB SUMMARY: The Specialist, Account Resolution is the lead responsible for the timely follow-up of Managed Care/Commercial accounts. Communicates clearly and efficiently by phone with health plans. Maintains productivity standards and reports. Responsible to obtain State collection guidelines if applicable. Reviews managed care contracts.
EDUCATION, EXPERIENCE, TRAINING
- 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
DUTIES AND RESPONSIBILITIES
1. Works account assigned to work list both expediently and thoroughly to expedite payment and final disposition of account.
2. Communicates effectively with patients, and other payers to facilitate payment in a timely fashion.
3. Makes clear legible notes in Medi-Tech pertaining to any collection efforts made on accounts. (Proper use of activity codes.)
4. Performs timely follow up and ensures appropriate action taken at system-mandated intervals.
5. Identifies Hospital/Corporate contracted payers.
6. Performs special projects and assignments in an accurate, efficient, and thorough manner.
7. Explains hospital deposit policies and payment arrangement standards.
8. Performs other duties as assigned or required.
9. Performs lead duties in order to assist with attainment of revenue cycle goals
10. Meets cash goal requirements and all other KPI’s
Job Type: Full-time
- hospital billing: 4 years (Required)
- hospital managed care: 4 years (Required)
- commercial collector: 4 years (Required)