Network Billing Associate

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.

We're proud to be recognized-again! For the fourth year in a row, we've been certified by Great Place to Work, and for the third consecutive year, we've 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 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

Qualifications :

Paradigm Benefits :

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.

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 leave.management@paradigmcorp.com.

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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