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Paradigm · 2 days ago

Network Billing Associate

Tampa, FL

Full-time

Hybrid

New Grad, Entry Level

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The Network Billing Associate is responsible for the intake, repricing and processing of all network bills adhering to established standards and practices, while providing exceptional customer service to internal and external customers.

Health CareHospitalMedical

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

Responsible for complying with Paradigm IT security requirement and policies

Responsible for safeguarding Paradigm or Paradigm related IT passwords

Responsible for notifying Paradigm of any IT security incidents per policy 16.0 Information Security Incident Management

Qualification

Healthcare billing experienceCPTICD10 codingBilling software experienceAttention to detailMicrosoft Office proficiencyCommunication skillsWork independently

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

Benefits

Health and wellness – We want our people to be and stay healthy, so we offer PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only).

Financial incentives – Paradigm’s financial benefits help prepare you for the future: competitive salaries, 401(k) matching contributions, employer-paid life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions.

Vacation - We believe strongly that work-life balance is good for you and for our company. Our paid time off and personal holiday programs give you the flexibility you need to live your life to the fullest.

Volunteer time – We want our employees to engage with and give back to their communities in meaningful ways. Full and part-time employees receive one paid day per calendar year.

Learning and development: One of Paradigm’s core values is expertise, so we encourage our employees to continually learn and grow. We support this in a variety of ways, including our new Learning Excellence at Paradigm (LEAP) program.