Senior Medicare/Medicaid Billing & Collections Specialist

Prime Healthcare Services; Inglewood (CA); On-site; USD 35,000 - 52,000; Full time

Job summary

Prime Healthcare is seeking a Senior Medicare-Medicaid Biller/Collector responsible for billing and collections in accordance with payer guidelines. This role includes maintaining deficiency lists, resolving claim rejections, and performing proactive follow-up with payers until accounts are paid.

The position emphasizes experience with hospital billing, multiple payer types, and regulatory compliance. Employment is full-time with day shifts.

Qualifications

• 3+ years hospital managed care/commercial collector experience.
• 2 years of 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. and the ability to cross-over into different payers.

Responsibilities

• Manage billing and collections for Medicare-Medicaid per payer guidelines.
• Maintain deficiency lists to obtain missing documents from internal or external entities.
• Resolve claim rejections and package claims with attachments.
• Perform proactive payer follow-up to secure payment.
• Billing through account closure and ensure accuracy.

Skills

Hospital billing experience

Medicare billing

Contract interpretation

Payer types knowledge

Out-of-state Medicaid billing

Regulatory knowledge

All payer types

Education

Associates degree or equivalent

Job description

Prime Healthcare is seeking a Senior Medicare-Medicaid Biller/Collector responsible for billing and collections in accordance with payer guidelines. This role includes maintaining deficiency lists, resolving claim rejections, and performing proactive follow-up with payers until accounts are paid.

The position emphasizes experience with hospital billing, multiple payer types, and regulatory compliance. Employment is full-time with day shifts.