What are the responsibilities and job description for the Sr. Commercial Payor Biller Collector position at Prime Healthcare?
Responsibilities
The Senior Commercial Payer 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 Commercial payers. 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.
#LI-BF3
Qualifications
EDUCATION, EXPERIENCE, TRAINING
1. Minimum of 5 years hospital commercial/government payor collector experience
2. Associates degree or equivalent work experience required
3. Knowledge of contract or summary plan description (SPD) interpretation
4. Familiar with hospital billing requirements
5. Understanding of managed care payor contract, contract or SPD language
6. Working experience with all payer types including commercial, governmental, Medicare, Medicaid, HMO, etc. and the ability to cross-over into different payers.
7. Prior knowledge or work experience in ERISA Collections is preferred
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