Senior Managed Care Billing & Collections Lead

Prime Healthcare; Ontario (CA); On-site; CAD 46,000 - 73,000; Full time

Job summary

Prime Healthcare is seeking a Senior Managed Care Biller/Collector to oversee billing and collections across multiple payers. You will gather documents, follow up on claims, and secure payment in line with payer rules and compliance regulations.

The role requires hospital managed care experience and familiarity with Medicaid/Medicare billing rules, with opportunity to impact revenue cycle outcomes and accuracy across the organization.

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 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 information per payer guidelines.
• Resolve claim rejections and perform proactive payer follow-up.
• Package claims with attachments and ensure billing through account closure.

Skills

Hospital managed care experience

Billing knowledge

Attention to detail

Education

Associates degree or equivalent work experience

Tools

Automated billing system

Job description

Prime Healthcare is seeking a Senior Managed Care Biller/Collector to oversee billing and collections across multiple payers. You will gather documents, follow up on claims, and secure payment in line with payer rules and compliance regulations.

The role requires hospital managed care experience and familiarity with Medicaid/Medicare billing rules, with opportunity to impact revenue cycle outcomes and accuracy across the organization.