Network Billing Associate

Location : Tampa, FL, USAReq Number : Req #1549Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigms business : risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs. Were proud to be recognizedagain!

For the fourth year in a row, weve been certified by Great Place to Work, and for the third consecutive year, weve earned a spot on Fortune's Best Workplaces in Health Care list. These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people thrive. Watch this short video for a brief introduction to Paradigm. The Network Billing Associate is responsible for the intake, repricing and processing of all network bills adhering to established standards and practices. Identify Provider documents and claim demographics to prepare a complete and accurate record for review. Assist with email inquiries from providers and / or clients with questions regarding claims. Have an outstanding attention to detail and possess a desire to succeed and progress quickly. Responsibilities :

Manage the day-to-day billing activitiesEnsure contractual and statutory billing complianceReview and comprehend documentation, fee schedule calculations and savings output to clients with the ability to identify inconsistenciesPrepare and analyze billing for various facility using appropriate coding and utilizing State StatutesProcess appeals and reconsiderations.Document / update information in cases with high degree of accuracyComplies 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 customersPerform additional support functions as neededResponsible for complying with Paradigm IT security requirement and policiesResponsible for safeguarding Paradigm or Paradigm related IT passwordsResponsible for notifying Paradigm of any IT security incidents per policy 16.0 Information Security Incident Management

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 typesEffective 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 regulationsPrior experience interacting with healthcare provider billing software and healthcare billing coding resource databasesExcellent communication skills both written and verbal, and internal personal skillsAbility to work independentlyAcute attention to detailProficient in all Microsoft Office and computer application systems Paradigm 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

Paradigms 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 Paradigms 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. Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. Were striving to build a culture that better reflects the society we live in and empowers our team to deliver the highest levels of compassion and care to those we serve. For us, achieving this goal requires a workforce that respectfully embraces differences and commits to positive change, creating an environment where everyone is able to bring their whole self to work. Paradigm complies with federal and state disability laws and makes reasonable accommodations for applicants and employees with disabilities. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and / or to receive other benefits and privileges of employment, please contact Leave Management at .

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.

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