Senior Managed Care Biller/Collector

OverviewParadise Valley Hospital is the South Bay's oldest hospital, the second oldest hospital in all of San Diego County, and the largest employer in National City. For more than 100 years, Paradise Valley Hospital has served San Diego faithfully, proud of our heritage and providing numerous programs and services to meet the changing needs of our community. Our 291-bed, acute care hospital features the San Diego Spine & Joint Center, a highly credentialed acute rehabilitation center, our Paradise Health & Senior Center, a fully equipped and modern cardiac catheterization lab, and comprehensive inpatient and outpatient surgical services, and 24-hour emergency services. Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Why Prime Healthcare? Paradise Valley Hospital; a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Paradise Valley Hospital offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to :

• Paid Time Off
• 401K Retirement Plan
• Outstanding Medical, Dental, Vision coverage
• Tuition Reimbursement
• Many more voluntary benefit options!Company is an equal opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local law. The company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights : https : / / www.eeoc.gov / sites / default / files / 2022-10 / EEOC_KnowYourRights_screen_reader_10_20.pdf Privacy Notice for California Applicants : https : / / www.primehealthcare.com / wp-content / uploads / 2024 / 04 / Notice-at-Collection-and-Privacy-Policy-for-California-Job-Applicants.pdfResponsibilitiesThe Senior Managed Care Biller / Collector is responsible for both billing and collections, gathering and securing all information needed for billing, follow up, and payment of accounts in accordance with the specific payer guidelines, policies, procedures, and compliance regulations for managed care. This includes maintaining the deficiency lists used to obtain missing documents from internal or external entities, resolving claim rejections, packaging claims, including global billing with attachments of professional fee claims, performing proactive follow up with payers and other entities and securing payment of accounts. The senior biller / collector is accountable and responsible for billing through account closure.QualificationsEDUCATION, EXPERIENCE, TRAINING1. Minimum of three years hospital managed care / commercial collector experience 2. 2 years of recent hospital managed care billing experience in an automated environment3. Associates degree or equivalent work experience required4. Knowledge of contract interpretation5. Familiar with hospital billing requirements6. Knowledge of out of state Medicaid billing guidelines7. Knowledge of basic managed care, Medicaid / Medicare billing rules, regulations, and deadline8. Working experience with all payer types including : commercial, governmental, Medicare, Medicaid, HMO, etc. and the ability to cross-over into different payers.Paradise Valley Hospital offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $XX.00 to $XX.00. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.