Senior Medicare & Medicaid Billing & Collections Specialist

Centinela Hospital Medical Center; Inglewood (CA); On-site; USD 35,000 - 52,000; Full time

Job summary

Prime Healthcare is seeking a Senior Medicare-Medicaid Biller/Collector to manage billing and collections for a broad range of payers. You will gather documentation, follow payer guidelines, and ensure timely payment.

This role requires hospital billing experience, Medicare and Medicaid knowledge, and ability to resolve claim rejections. Join a growing team within Prime Healthcare's California network.

Qualifications

• Minimum of three years hospital managed care/commercial collector experience.
• 2 years of recent hospital Medicare billing experience in an automated environment.
• Associates degree or equivalent work experience required.
• Knowledge of contract interpretation.
• Familiar with hospital billing requirements.
• Knowledge of out of state Medicaid billing guidelines.
• Knowledge of basic Medicaid/Medicare billing rules, regulations, and deadline.
• Working experience with all payer types including: commercial, governmental, Medicare, Medicaid, HMO, etc.

Responsibilities

• Responsible for billing and collections, gathering and securing all information needed for billing, follow up, and payment of accounts in accordance with payer guidelines.
• Maintain deficiency lists used to obtain missing documents from internal or external entities.
• Resolve claim rejections and package claims, including attachments of professional fee claims.
• Proactive follow up with payers and other entities to secure payment of accounts through account closure.

Skills

Medicare billing

Medicaid billing

Hospital billing

Managed care

Payer follow-up

Contract interpretation

Education

Associates degree

Job description

Prime Healthcare is seeking a Senior Medicare-Medicaid Biller/Collector to manage billing and collections for a broad range of payers. You will gather documentation, follow payer guidelines, and ensure timely payment.

This role requires hospital billing experience, Medicare and Medicaid knowledge, and ability to resolve claim rejections. Join a growing team within Prime Healthcare's California network.