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.
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.
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