Junior Case Manager

at  PrimeMSOSurgicalCenters Headquarters

JOB DESCRIPTION

The Jr. Case Manager primarily handles billing processing and collections on medical claims for multispecialty Ambulatory Surgery Centers. This role will manage patient billing processes, ensure accurate and timely submission of claims, and facilitate the resolution of billing issues. This role requires strong organizational skills, exceptional attention to detail, and the ability to communicate effectively with patients, insurance companies, and healthcare providers. The Billing Case Manager will also be responsible for maintaining accurate records, preparing financial reports, submitting appeals, records and managing the complete revenue cycle of accounts. This position will require Case Managers to manage revenue cycle best practices as they relate to the organization’s revenue cycle management processes and staying up to date with industry regulations and coding standards.

SKILLS AND QUALIFICATIONS:

• Knowledge and understanding of PPO/Federal/HMO/POS Health Plan Benefits.
• Strong knowledge of medical billing codes, regulations, and insurance processes.
• Knowledge of billing guidelines for contracted and non-participated Ambulatory Surgery Centers.
• Knowledge of multiple medical billing functions in the revenue cycle management lifecycle.
• Insurance correspondence resolution and appeals overview and submission.
• Ability to identify problems and demonstrate reliability & ability to communicate constructively, Strong verbal and written communication skills
• Knowledge and understanding of facility billing for in-network, federal, out-of-network and non-participated providers.
• Ability to work independently and as part of a team.
• Ability to identify issues and barriers, find solutions, and evaluate the success of their ideas.
• Detail-oriented with a commitment to accuracy and compliance.
• Microsoft Office Suite - highly proficient.
• Bachelor’s degree in healthcare administration, business, or a related field. (Preferred)

REQUIREMENTS:

• Minimum of 1-3 years of experience in medical billing and collections, with a focus on revenue cycle management.
• Federal/In-network/Out-of-Network payor knowledge - all payors
• Dept of Justice Background Check
• Satisfactory Completion of Health/Drug Screening
• Proof legal US work eligibility
• Valid CA Class C Drivers License

COMPANY DESCRIPTION

Since 2014, Prime MSO has developed and managed surgical facilities that provide patients with the highest level of surgical care. Today we are one of the reliable and independent operators of outpatient surgery centers in the Los Angeles area, covering virtually the full range of surgical specialties.
Our remarkable community of teammates, physician partners and health system partners are deeply committed to providing quality patient care and improving healthcare in America. Our focus on building strategic relationships with our partners enables us to acquire, develop and optimize facilities in an aligned economic model that enables better access to high-quality care at a lower cost.
While healthcare is in a constant state of change, we want to make sure it is always for the better. We believe that happier, more fulfilled employees and staff in a fun and dynamic work environment will ultimately provide the best care in the country. At Prime MSO, that means success. Talk to any of our employees about their experiences and hear the difference Prime MSO is making in their lives today.

Please refer the Job description for details