Sr. Managed Care Biller/Collector

Prime Healthcare•Ontario, CA

14h•$21 - $38

About The Position

Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 51 hospitals and has more than 360 outpatient locations in 14 states providing more than 2.5 million patient visits annually. It is one of the nation’s leading health systems with nearly 57,000 employees and physicians. Eighteen 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! 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

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
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