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McLaren Health Care Account Resolution Spec in Troy, Michigan


Under close supervision, responsible for the day-to-day activities related to resolution of patient accounts up to and including adding or updating ICD-9-CM, CPT and HCPCS codes. Moving charges, identifying proper placement of charges that are posted in error or missing account information. Utilizes experience based knowledge in order to problem solve difficult accounts and identify solutions to such problems. Review and recommend changes in departmental policies and procedures related to timely account resolution. Provide consistent feedback to the front end of the revenue cycle to prevent further rework of accounts.

Essential Functions and Responsibilities:

Business Account Resolution Specialist:

  • Works various reports related to account resolution including but not limited to the TCE report, bill holds, outpatient exception report, etc.

  • Works with other departments to resolve problems associated with the resolution of patient accounts.

  • Provides support to the clinical auditors as needed. Duties include adding or updating ICD-9-CM, CPT and HCPCS codes. Moving charges, copying medical records, logging/monitoring auditing requests.

  • Log and monitor all incoming requests/inquiries of the account resolution team.

  • Compiles various reports and statistics for management, as requested. Completes special projects or assignments, as assigned.

Pharmacy Account Resolution Specialist

  • Establishes and maintains relationships with third-party payors, PBMs, and government payors (Medicaid and Medicare), participates in the manufacturer contracting process.

  • Regularly monitors open patient account balances and OAR, and communicates this information to department leadership to identify opportunities for increased collections

  • Reviews patient account aging weekly for collection opportunities.

  • Monitors write-off trends, OAR, credit reviews, payment arrangements and collection balances to identify opportunities for improvement

  • Facilitates accounts receivable reduction to ensure OAR goals



  • High school diploma required

  • One of the following credentials:CCS Certified Coding SpecialistCPC-H Certified Professional Coder-HospitalCPC Certified Professional CoderRadiology Certified Coder (RCC)

  • Two to three years of experience with hospital registration, health insurance and patient accounting type functions.

Pharmacy Only

  • High school diploma required

  • One of the above business certifications or

  • Valid Michigan Pharmacy Technician license or

Equal Opportunity Employer of Minorities/Females/Disabled/Veterans

  • Associate’s degree in business, finance, accounting, or health related field.

Job: Non-Health Professional

Primary Location: Michigan-Troy-Specialty Pharmacy

Employee Status Regular

Shift Day Job

Job Type Standard

Schedule Full-time

Req ID: 20007060