Senior Managed Care Billing & Collections Specialist

Centinela Hospital Medical Center; Ontario (CA); On-site; USD 33,000 - 52,000; Full time

Job summary

Prime Healthcare in Ontario, California, seeks a Senior Managed Care Biller/Collector to handle billing and collections per payer guidelines and compliance. You will maintain deficiency lists, resolve claim rejections, and follow up with payers to ensure timely payments.

This full-time role requires hospital experience and knowledge of Medicaid/Medicare rules. The position offers competitive pay and a comprehensive benefits package within a large health system, with opportunities for growth in a

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.

Responsibilities

• Billing and collections following payer guidelines and compliance.
• Maintain deficiency lists to obtain missing documents.
• Resolve claim rejections and package claims with attachments.
• Perform proactive follow up with payers and other entities to secure payment.
• Billing through account closure.

Skills

Hospital managed care billing

Deficiency list management

Payer follow-up and payment processing

Medicaid/Medicare billing rules

Cross-payer experience

Contract interpretation

Out-of-state Medicaid billing guidance

All payer types experience

Education

Associates degree or equivalent work experience

Job description

Prime Healthcare in Ontario, California, seeks a Senior Managed Care Biller/Collector to handle billing and collections per payer guidelines and compliance. You will maintain deficiency lists, resolve claim rejections, and follow up with payers to ensure timely payments.

This full-time role requires hospital experience and knowledge of Medicaid/Medicare rules. The position offers competitive pay and a comprehensive benefits package within a large health system, with opportunities for growth in a