Senior Managed Care Billing & Collections Specialist

Saint Mary's Health Network; Ontario (CA); On-site; USD 33,000 - 52,000; Full time

Job summary

Prime Healthcare in California is seeking a Senior Managed Care Biller/Collector to manage billing and collections for managed care, ensuring all payer requirements are met. You will gather needed information, follow up on denials, and package claims with attachments to secure timely payments.

Responsibilities include proactive payer follow up, resolving claim rejections, and billing accounts through closure, while adhering to regulations and internal policies.

Qualifications

• 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.

Responsibilities

• Handle billing and collections for managed care accounts.
• Gather and secure information needed for billing and payment.
• Follow payer guidelines and compliance regulations.
• Resolve claim rejections and package claims with attachments.
• Proactive follow up with payers to secure payment.
• Bill accounts through closure.

Skills

Hospital billing

Managed care

Billing regulations

Payer knowledge

Out-of-state Medicaid

Education

Associate degree

Tools

Automated billing systems

Job description

Prime Healthcare in California is seeking a Senior Managed Care Biller/Collector to manage billing and collections for managed care, ensuring all payer requirements are met. You will gather needed information, follow up on denials, and package claims with attachments to secure timely payments.

Responsibilities include proactive payer follow up, resolving claim rejections, and billing accounts through closure, while adhering to regulations and internal policies.