Sr. Managed Care Biller/Collector

Prime Healthcare • Ontario, CA

1d • $21 - $38

About The Position

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 54 hospitals and has more than 360 outpatient locations in 15 states providing more than 3.0million patient visits annually. It is one of the nation’s leading health systems with over 60,000 employees and physicians. Twenty-one 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! #LI-JV1 Responsibilities 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

• 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
• 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
• accountable and responsible for billing through account closure

Benefits

• Prime Healthcare 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees