Sr Managed Care Biller/Collector

Overview

Paradise Valley Hospital, a member of Prime Healthcare, offers opportunities to be part of a community dedicated to making a difference. The hospital is the South Bay's oldest hospital, the second oldest in San Diego County, and the largest employer in National City. This 291-bed acute care facility features the San Diego Spine & Joint Center, a rehabilitation center, the Paradise Health & Senior Center, a cardiac catheterization lab, comprehensive surgical services, 24-hour emergency services, and behavioral health services on the hospital campus and Bayview campus in Chula Vista.

Responsibilities

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

Qualifications

• 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 required
• 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 deadlines
• Working experience with all payer types including: commercial, governmental, Medicare, Medicaid, HMO, etc. and the ability to cross-over into different payers

Pay

A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $24.06 to $38.00. The exact starting compensation will be determined at the time of selecting an applicant for hire, considering skillset, years of applicable experience, education, credentials, and licensure.

Benefits

• Paid time off
• 401K retirement plan
• Medical, dental, and vision coverage
• Tuition reimbursement
• Voluntary benefit options