Network Billing Associate at Paradigm in Tampa, Florida

Job Description:

Location: Tampa, FL, USA
Req Number: Req #1319

Paradigm 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 Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.

Paradigm is seeking a full-time Network Billing Associate. The Network Billing Associate is responsible for the intake, repricing and processing of all network bills adhering to established standards and practices. The ideal candidate will have excellent communication and customer service skills, outstanding attention to detail and possess a desire to succeed and progress quickly.

This position will start out in the Tampa office with eventual option for hybrid between office and remote work.

What you will do:

• Manage 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, and comply 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.

Skills and Experience

• Experience with 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
• Proficient in all Microsoft Office and computer application systems

What we offer:

• Health and wellness: We want our people to be and stay healthy so we offer a wide variety of HMO, PPO, and HDHP health insurance options with both Cigna and Kaiser Health.
• Financial incentives: Paradigm’s financial benefits also help prepare you for the future: competitive salaries, flexible spending, commuter accounts, paid life insurance, employer HSA, and 401k contributions.
• Vacation: We believe strongly that work-life balance is good for you and for our company. Our paid time off and floating-holiday programs give you the flexibility you need to live your life to the fullest.
• 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.

Paradigm believes that fostering a diverse and inclusive workplace is central to our mission of helping more people and transforming lives. We’re 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.

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.

Other details



Equal employment opportunity, including veterans and individuals with disabilities.

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