[Hiring] Network Services Associate @Paradigm

Role Description

The Network Services Associate will handle data entry, analyze data sets, handle incoming Provider bill status emails, and process reconsiderations, disputes, and state disputes.

• Respond to email bill inquiries and disputes from providers, clients, and internal customers.
• Work with Finance, Provider Management, and external network partners to resolve provider disputes and questions.
• Work with clients to resolve pricing issues and state disputes within regulatory timeframes.
• Treat all customers, internal and external, in a courteous and cooperative manner by providing exceptional customer service.
• Understand and comply with all HIPAA & SOC2 requirements necessary in working with designated PHI.
• Document and update information in cases and billing systems with a high degree of accuracy.
• Utilize critical thinking skills while handling billing issues.
• Assist with training team members and new staff as needed.
• Process reconsiderations per client-specific procedures.
• Perform additional duties as identified and directed by management.
• Maintain reliable and predictable attendance during scheduled work hours.

Qualifications

• College education preferred with a minimum of two years in a clerical setting (preferably healthcare).
• Prefer either workers’ compensation or call center experience.
• Excellent communication skills both written and verbal.
• Acute attention to detail.
• Proficient in all Microsoft Office and computer application systems.
• Ability to express ideas clearly, concisely, and effectively, verbally and in writing.
• Working knowledge and 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 knowledge.
• Ability to work independently.
• Medical office or insurance experience a plus.
• Bilingual (English/Spanish) a plus.

Benefits

• Health and wellness: PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only).
• Financial incentives: Competitive salaries, 401(k) matching contributions, employer-paid life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions.
• Vacation: Paid time off and personal holiday programs for work-life balance.
• Volunteer time: One paid day per calendar year for community engagement.
• Learning and development: Support for continual learning and growth through the Learning Excellence at Paradigm (LEAP) program.