Sr Managed Care Biller/Collector

About the role

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.

Responsibilities

• Gather and secure 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.
• Maintain the deficiency lists used to obtain missing documents from internal or external entities.
• Resolve claim rejections.
• Packaging claims, including global billing with attachments of professional fee claims.
• Perform proactive follow up with payers and other entities and secure payment of accounts.
• Billing through account closure.

Requirements

• Minimum of three years hospital managed care/commercial collector experience
• Two 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 deadlines
• Working experience with all payer types including commercial, governmental, Medicare, Medicaid, HMO, etc. and the ability to cross-over into different payers.

Qualifications

• Education: Associates degree or equivalent work experience preferred

Skills

• Contract interpretation
• Hospital billing requirements
• Managed care, Medicaid/Medicare billing rules, regulations, and deadlines
• Ability to cross-over into different payers

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.

Pay

A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $23.94 to $38.00. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

Schedule

Full Time Days

Benefits

Our benefits 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.