Senior Managed Care Billing & Collections Specialist

Prime Healthcare Services; 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 oversee billing, follow-up, and collections across payer types, ensuring compliance and timely payment.

The role requires 3+ years hospital managed care billing, knowledge of Medicaid/Medicare rules, and ability to perform global billing with attachments. Full-time, day shift with a comprehensive benefits package.

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 and hospital billing requirements.
• Familiar with out of state Medicaid billing guidelines and basic managed care rules.
• Experience with multiple payer types including commercial, governmental, Medicare, and Medicaid.

Responsibilities

• Billing and collections across managed care payer guidelines and compliance requirements.
• Maintain deficiency lists and follow up to secure missing documents; resolve claim rejections and ensure account closure.

Skills

Managed care billing

Hospital billing

Medicaid/Medicare rules

Payer types

Contract interpretation

Out of state Medicaid

Billing compliance

Automated billing systems

Education

Associates degree or equivalent

Job description

Prime Healthcare in Ontario, California, seeks a Senior Managed Care Biller/Collector to oversee billing, follow-up, and collections across payer types, ensuring compliance and timely payment.

The role requires 3+ years hospital managed care billing, knowledge of Medicaid/Medicare rules, and ability to perform global billing with attachments. Full-time, day shift with a comprehensive benefits package.