Network Billing Associate

Paradigm • Tampa, FL

85d

About The Position

The Network Billing Associate is responsible for the intake, repricing and processing of all network bills adhering to established standards and practices. Identify Provider documents and claim demographics to prepare a complete and accurate record for review. Assist with email inquiries from providers and/or clients with questions regarding claims. Have an outstanding attention to detail and possess a desire to succeed and progress quickly.

Requirements

• Strong experience of medical insurance/healthcare billing in a medical clinic and/or healthcare system, institutional post-acute care provider or medical practice including workers’ compensation, commercial insurance, CMS-Medicare and state Medicaid payor types
• Effective skills in creating institutional provider billing from primary source charge data for Skilled Nursing Facilities, Long Term Acute Care Hospitals, Inpatient Rehabilitation Hospitals, Home Health Services in both commercial insurance and CMS-Medicare billing environments
• Thorough knowledge and working experience with CPT, ICD10, MS-DRG, LTC-DRG, CMG, PDPM, HHRG bill coding systems, UB and HCFA claim forms and correct data field entries for all fields on both standard billing documents, medical terminology, and billing regulations
• Prior experience interacting with healthcare provider billing software and healthcare billing coding resource databases
• Excellent communication skills both written and verbal, and internal personal skills
• Ability to work independently
• Acute attention to detail
• Proficient in all Microsoft Office and computer application systems

Responsibilities

• Manage the day-to-day billing activities
• Ensure contractual and statutory billing compliance
• Review and comprehend documentation, fee schedule calculations and savings output to clients with the ability to identify inconsistencies
• Prepare and analyze billing for various facility using appropriate coding and utilizing State Statutes
• Process appeals and reconsiderations
• Document/update information in cases with high degree of accuracy
• Complies with and adheres to all regulatory compliance areas, policies and procedures and best practices
• Understand and comply with all HIPAA & SOC2 requirements necessary in working with designated PHI
• Provide exceptional customer service to internal and external customers
• Perform additional support functions as needed
• Responsible for complying with Paradigm IT security requirement and policies
• Responsible for safeguarding Paradigm or Paradigm related IT passwords
• Responsible for notifying Paradigm of any IT security incidents per policy 16.0 Information Security Incident Management

Benefits

• PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only)
• Competitive salaries
• 401(k) matching contributions
• Employer-paid life and disability insurance
• Flexible spending and commuter accounts
• Employer-matched HSA contributions
• Paid time off and personal holiday programs
• One paid day per calendar year for volunteer time
• Learning Excellence at Paradigm (LEAP) program

What This Job Offers

• Number of Employees: 251-500 employees