Job Description

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.

Paradigm is seeking a detail-oriented Billing Associate to support the management of provider requests for additional reimbursement. In this role, you will review and enter claim-related information into company systems, perform initial assessments of reconsideration requests, and collaborate with internal teams to ensure accurate and timely claim processing. The ideal candidate has experience in medical billing, strong analytical skills, and a customer-first mindset with a commitment to delivering exceptional service to providers, clients, injured workers, and internal stakeholders.

Responsibilities

• Review, interpret, and accurately enter reconsideration information into company systems.
• Analyze claim documentation and identify inconsistencies or missing information.
• Review supporting documents including: UB-04 forms, HCFA/CMS-1500 forms, superbills, manufacturer invoices, implant logs, operative reports.
• Determine when claims require additional bill review.
• Complete reconsideration requests accurately and timely.
• Communicate with providers, billing representatives, attorneys, and internal teams regarding reimbursement requests.Maintain compliance with all privacy, security, and PHI/ePHI requirements.
• Deliver exceptional customer service while managing multiple priorities and deadlines.

Required qualifications

• Associate degree or equivalent combination of education and experience.
• Experience with Microsoft Office and computer application systems.
• Customer service experience in a call center, production, or client-facing environment.
• Knowledge of medical billing, medical terminology, and surgical implants.
• Strong attention to detail and organizational skills.Proven critical thinking and problem-solving abilities.
• Excellent verbal and written communication skills.
• Ability to manage multiple tasks while maintaining accuracy and quality.Minimum typing speed of 45 WPM.

Preferred qualifications

• Experience working with insurance companies or healthcare service organizations.
• Bilingual in English and Spanish.

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 – Paradigm’s 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 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.

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.

As a contractor with the State of Wisconsin, Paradigm complies with Wisconsin Contract Compliance Law (§16.765). Poster link: Contract Compliance Law Poster

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