Accounts Receivable HMO Billing Specialist
About The Position
A healthcare financial services company is seeking an experienced Accounts Receivable HMO Billing Specialist to handle billing and receivables for a group of skilled nursing facilities. This role will be responsible for HMO billing related functions across multiple entities, ensuring claims are submitted accurately, payments are properly tracked, and outstanding receivables are closely monitored. The Accounts Receivable HMO Billing Specialist will handle Managed Medicaid, MLTC, and Commercial plan claims while working closely with business office staff. Responsibilities include reviewing census information and authorizations, billing for services, monitoring collections and payments, conducting audits, and reviewing aging reports. The ideal candidate has direct skilled nursing or post acute HMO billing experience and is comfortable managing multiple payer types, accounts, and month end deadlines in a fast paced environment.
Requirements
- Minimum 2 years of HMO billing experience in healthcare Accounts Receivable required
- Skilled nursing, rehabilitation, or post acute facility billing experience required
- Experience with Skilled Nursing Facility Accounts Receivable billing
- Nursing home A/R bookkeeping experience
- Experience with HMO billing systems and common working files
- Familiarity with CMS regulations
- Strong understanding of Managed Medicaid, MLTC, and Commercial plan billing
- Ability to manage multiple projects, payer types, and deadlines
- Strong attention to detail and problem solving skills
- Excellent computer and communication skills
- Ability to work effectively with business office managers and executive leadership
Responsibilities
- Manage HMO billing for skilled nursing facilities
- Bill Managed Medicaid, MLTC, and Commercial plan claims
- Review census data and authorizations for billing accuracy
- Submit claims and monitor collections and payments
- Track outstanding receivables and review aging reports
- Identify and follow up on troubled or growing accounts and payer issues
- Conduct audits and ensure billing compliance
- Work closely with business office managers and facility staff
- Manage billing responsibilities across multiple entities
- Maintain accurate Accounts Receivable records
- Support month end close requirements and deadlines
- Communicate account and payer issues clearly to executive leadership
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
