Senior Managed Care Billing & Collections Specialist

St. Mary's General Hospital; Ontario (CA); Presencial; USD 33.000 - 52.000; Jornada completa

Descripción de la vacante

Prime Healthcare in Ontario, California seeks a Senior Managed Care Biller/Collector to handle billing and collections for multiple payer types in a hospital setting. You will secure timely payments by following payer guidelines, resolving denials, and finalizing claims through account closure.

This full-time day shift role requires solid experience in hospital managed care billing, strong knowledge of Medicaid/Medicare rules, and the ability to manage complex claim cycles across commercial and

Formación

• Minimum of three years hospital managed care/commercial collector experience.
• Two years of recent hospital managed care billing in an automated environment.
• Knowledge of contract interpretation and hospital billing requirements.
• Familiar with various payer types including commercial, governmental, Medicare, Medicaid, and HMO.
• Knowledge of Medicaid/Medicare billing rules, regulations, and deadlines.

Responsabilidades

• Bill and collect for managed care accounts following payer guidelines and compliance.
• Maintain deficiency lists and obtain missing documents from internal/external entities.
• Resolve claim denials and perform global billing with attachments.
• Proactively follow up with payers to secure payment and ensure account closure.

Conocimientos

Contract interpretation

Cross-functional collaboration

Regulatory compliance

Billing knowledge

Negotiation skills

Educación

Associates degree or equivalent

Descripción del empleo

Prime Healthcare in Ontario, California seeks a Senior Managed Care Biller/Collector to handle billing and collections for multiple payer types in a hospital setting. You will secure timely payments by following payer guidelines, resolving denials, and finalizing claims through account closure.

This full-time day shift role requires solid experience in hospital managed care billing, strong knowledge of Medicaid/Medicare rules, and the ability to manage complex claim cycles across commercial and