Sr Medicare Medicaid Biller Collector

Prime Healthcare Management Inc•Inglewood, CA

1d•Onsite

About The Position

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 3.0 million 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! The Senior Medicare-Medicaid 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 Medicare-Medicaid. 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 Medicare billing experience in an automated environment.
Associates degree or equivalent work experience required.
Knowledge of contract interpretation.
Familiar with hospital billing requirements.
Knowledge of out of state Medicaid billing guidelines.
Knowledge of basic 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 Medicare-Medicaid.
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.