Senior Managed Care Biller Collector - Prime Healthcare Management Inc

St. Francis Medical Center is one of the leading comprehensive healthcare institutions serving Southeast Los Angeles. St. Francis is dedicated to providing vital healthcare services for the 700,000 adults and 300,000 children who count on the hospital for high quality and compassionate medical care. St. Francis is recognized for its full range of diagnostic and treatment services in specialties including Cardiovascular, Surgical, Orthopedics, Maternal-Child Health, Behavioral Health and Emergency and Trauma Care.  In addition, the hospital offers a broad array of education and outreach programs that advance community health. St. Francis Medical Center is a Certified Primary Stroke Center, Approved STEMI Receiving Center for Los Angeles County and designated Baby-Friendly healthcare facility by Baby-Friendly USA. Please visit www.stfrancismedicalcenter.comfor more information.

Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community!

Why Prime Healthcare? St. Francis Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.

St. Francis Medical Center 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!

Benefits may vary based on collective bargaining agreement requirements and/or the employment status, i.e. full-time or part-time.

We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics.  If you need special accommodation for the application process, please contact Human Resources.  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.pdf

The 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.

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EDUCATION, EXPERIENCE, TRAINING

1.    Minimum of three years hospital managed care/commercial collector experience

2.    2 years of recent hospital managed care billing experience in an automated environment

3.    Associates degree or equivalent work experience required

4.    Knowledge of contract interpretation

5.    Familiar with hospital billing requirements

6.    Knowledge of out of state Medicaid billing guidelines

7.    Knowledge of basic managed care, Medicaid/Medicare billing rules, regulations, and deadline

8.    Working experience with all payer types including: commercial, governmental, Medicare, Medicaid, HMO, etc. and the ability to cross-over into different payers.

Prime Healthcare 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 $20.00 to $38.00. 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.