Senior Managed Care Biller/Collector

Prime Healthcare Management Inc•Ontario, CA

7d•$24 - $38

About The Position

The Senior Managed Care Biller/Collector is responsible for billing and collections, gathering and securing all information needed to bill, follow up, and obtain payment on accounts in accordance with payer guidelines, policies, procedures, and managed care compliance regulations. The role maintains deficiency lists to obtain missing documents from internal or external entities, resolves claim rejections, packages claims—including global billing with professional fee claim attachments—and proactively follows up with payers and other entities to secure payment. The senior biller/collector is accountable for the billing process through account closure. Prime Healthcare is an award-winning health system headquartered in Ontario, California, operating 54 hospitals and more than 360 outpatient locations in 15 states. It has over 60,000 employees and physicians and provides more than 3 million patient visits annually. Twenty-one of its hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity.

Requirements

At least three years of hospital managed care/commercial collector experience.
Two years of recent hospital managed care billing experience in an automated environment.
Knowledge of contract interpretation.
Familiarity with hospital billing requirements.
Knowledge of out-of-state Medicaid billing guidelines.
Knowledge of basic managed care and Medicaid/Medicare billing rules, regulations, and deadlines.
Experience working with all payer types, including commercial, governmental, Medicare, Medicaid, and HMO, and ability to transition across payer types.

Nice To Haves

Associate degree or equivalent work experience preferred.

Responsibilities

Gather and secure all information needed for billing, follow-up, and payment of accounts in accordance with payer guidelines, policies, procedures, and compliance regulations.
Maintain deficiency lists to obtain missing documents from internal or external entities.
Resolve claim rejections and package claims, including global billing with attachments of professional fee claims.
Proactively follow up with payers and other entities and secure payment of accounts.
Manage billing through account closure.