Paradigm · 6 days ago
Network Billing Associate
Paradigm is seeking a Network Billing Associate responsible for the intake, repricing, and processing of all network bills while adhering to established standards and practices. The role involves managing billing activities, ensuring compliance, and providing exceptional customer service to both internal and external customers.
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
Qualification
Required
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
Company
Paradigm
Paradigm achieves leading clinical and financial results for catastrophic and complex claims.
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
Neuberger Berman Capital Solutions
2025-07-02Private Equity
2018-09-20Acquired
Leadership Team
D
D. Nathan
Founder
Recent News
2025-12-10
2025-07-02
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