Risevoic
Account Resolution Specialist
Company : Prime Healthcare Services
Location : Denville, NJ, 07834
Job Type : Full Time
Date Posted : 2 January 2026
Overview
Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!
Responsibilities
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.
Qualifications
1. Minimum of four years hospital managed care/commercial collector experience required.
2. Bachelor’s degree or equivalent work experience preferred
3. Knowledge of contract interpretation
4. Familiar with hospital billing requirements
Pay Transparency
Prime Healthcare Management Inc offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $17.00 to $27.83 per hour. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.
Employment Status
Full TimeShift
DaysEqual 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
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Frequently asked questions
An Account Resolution Specialist primarily focuses on resolving payment discrepancies and managing follow-ups with insurance companies, while an Accounts Receivable Specialist often handles billing and payment processing. The resolution specialist requires deep contract interpretation skills crucial for healthcare billing nuances.
Success in Denville demands strong communication with regional health plans, knowledge of New Jersey's state collection guidelines, and familiarity with hospital billing. Analytical abilities combined with understanding commercial managed care contracts boost effectiveness in this role.
Yes, many specialists transition into senior account management or strategic account roles. Gaining expertise in contract negotiation and compliance can open pathways to leadership positions, especially in expansive systems like Prime Healthcare Services.
Prime Healthcare emphasizes a comprehensive benefits package tailored for employee flexibility and invests in ongoing education like tuition reimbursement. Their focus on timely managed care follow-up and state guideline adherence creates a structured yet supportive work environment.
The culture fosters collaborative communication with health plans and prioritizes equal employment opportunity, ensuring respectful interactions. This environment encourages transparency and adherence to compliance, which directly impacts daily account resolution tasks.
The typical compensation spans from $17.00 to $27.83 per hour, reflecting experience and education levels. This range aligns with regional healthcare industry standards, factoring in benefits like medical coverage and retirement plans offered by employers.
Denville's position within New Jersey's growing healthcare hub increases demand for specialists skilled in managed care collections. The proximity to major hospitals and outpatient centers fuels competitive hiring, especially for candidates knowledgeable in state-specific billing regulations.
The healthcare sector in Denville features moderate competition, with Prime Healthcare Services being a prominent employer. Candidates with a blend of hospital collection experience and contract interpretation skills tend to stand out during recruitment.
Advanced understanding of managed care contracts coupled with at least four years in hospital collections sets top performers apart. Additionally, a bachelor's degree or equivalent experience enhances analytical and communication capabilities essential for this role.
Navigating complex insurance policies and timely follow-up with diverse health plans requires meticulous attention. Balancing productivity standards while ensuring compliance with state collection laws can be demanding but is vital to maintaining efficient account recovery.