Network Billing Associate

1 hour ago

Tampa, Florida, United States Paradigm Full time

The
Network Billing Associate
is responsible for the intake, repricing, and processing of all network bills while adhering to established standards and practices. This role involves identifying provider documents and claim demographics to prepare a complete and accurate record for review. You will also assist with email inquiries from providers and/or clients regarding claims. The ideal candidate will have outstanding attention to detail and a strong desire to succeed and progress quickly.

Work Location & Schedule:
This position requires reporting to the
Tampa office for the first 90 days
for onboarding and training. After this initial period, the role transitions to a
hybrid schedule
, offering a blend of in-office and remote work.

Responsibilities:

  • Manage the day-to-day billing activities
  • Ensure contractual and statutory billing compliance
  • Review and comprehend documentation, fee schedule calculations and savings output to clients with the ability to identify inconsistencies
  • Prepare and analyze billing for various facility using appropriate coding and utilizing State Statutes
  • Process appeals and reconsiderations.
  • Document/update information in cases with high degree of accuracy
  • Complies with and adheres to all regulatory compliance areas, policies and procedures and best practices.
  • Understand and comply with all HIPAA & SOC2 requirements necessary in working with designated PHI.
  • Provide exceptional customer service to internal and external customers
  • Perform additional support functions as needed

Qualifications:

  • Strong experience of medical insurance/healthcare billing in a medical clinic and/or healthcare system, institutional post-acute care provider or medical practice including workers' compensation, commercial insurance, CMS-Medicare and state Medicaid payor types
  • Effective skills in creating institutional provider billing from primary source charge data for Skilled Nursing Facilities, Long Term Acute Care Hospitals, Inpatient Rehabilitation Hospitals, Home Health Services in both commercial insurance and CMS-Medicare billing environments
  • Thorough knowledge and working experience with CPT, ICD10, MS-DRG, LTC-DRG, CMG, PDPM, HHRG bill coding systems, UB and HCFA claim forms and correct data field entries for all fields on both standard billing documents, medical terminology, and billing regulations
  • Prior experience interacting with healthcare provider billing software and healthcare billing coding resource databases
  • Excellent communication skills both written and verbal, and internal personal skills
  • Ability to work independently
  • Acute attention to detail
  • Proficient in all Microsoft Office and computer application systems

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