Sr. Managed Care Biller/Collector

Prime Healthcare Management Inc•Victorville, CA

2d•$21 - $38

About The Position

The Senior Managed Care Biller/Collector is responsible for both billing and collections, gathering and securing all information needed for billing, follow up, and payment of accounts in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for managed care. This includes maintaining the deficiency lists used to obtain missing documents from internal or external entities, resolving claim rejections, packaging claims, including global billing with attachments of professional fee claims, performing proactive follow up with payers and other entities and securing payment of accounts. The senior biller/collector is accountable and responsible for billing through account closure.

Requirements

Minimum of three years hospital managed care/commercial collector experience
2 years of recent hospital managed care billing experience in an automated environment
Associates degree or equivalent work experience preferred
Knowledge of contract interpretation
Familiar with hospital billing requirements
Knowledge of out of state Medicaid billing guidelines
Knowledge of basic managed care, Medicaid/Medicare billing rules, regulations, and deadline
Working experience with all payer types including commercial, governmental, Medicare, Medicaid, HMO, etc. and the ability to cross-over into different payers.

Responsibilities

billing
collections
gathering and securing all information needed for billing
follow up
payment of accounts in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for managed care
maintaining the deficiency lists used to obtain missing documents from internal or external entities
resolving claim rejections
packaging claims, including global billing with attachments of professional fee claims
performing proactive follow up with payers and other entities and securing payment of accounts
billing through account closure