Billing and Reimbursement Specialist
About The Position
Kendal~Crosslands Communities (KCC) is seeking an experienced Billing & Reimbursement Specialist to join our Finance team. This role is central to accurate resident billing and healthcare reimbursement and will help advance the modernization of our billing systems and processes. In this role, you will manage resident billing, Medicare and other third-party reimbursement, accounts receivable, and related financial processes. The successful candidate will bring strong attention to detail, excellent communication skills, and relevant healthcare billing experience, along with the ability to collaborate effectively with Finance, Health Services, residents, and external partners.
Requirements
- Prior healthcare, Medicare, medical billing, reimbursement, and accounts receivable experience required.
- Familiarity with medical terminology, diagnosis/procedure coding concepts, and healthcare reimbursement.
- Strong computer skills, including Excel and electronic billing/EHR systems.
- Ability to learn new technology and adapt to evolving billing processes.
- Strong analytical, organizational, and problem-solving skills.
- High degree of accuracy and attention to detail.
- Ability to communicate clearly and professionally with residents, families, clinical staff, insurers, and colleagues.
- Ability to manage deadlines and competing priorities with minimal supervision.
- Demonstrated discretion and ability to maintain confidential and protected health information.
Nice To Haves
- Experience with Medicare SNF billing, Medicare Part A and Part B, consolidated billing, claims follow-up, and third-party insurance is highly desirable.
- Revenue cycle experience in skilled nursing, senior living, healthcare, or a Medicare-certified provider setting.
- Experience with PointClickCare (PCC) or similar healthcare billing/EHR systems.
- Experience reconciling accounts receivable to the general ledger.
Responsibilities
- Prepare and review monthly resident billing, including recurring fees, meal-plan adjustments, credits, ancillary charges, and other resident activity.
- Respond to resident and representative questions regarding billing and account activity.
- Support Medicare billing for skilled nursing and other covered services, including claim preparation, submission, payment posting, coinsurance billing, denials, and follow-up.
- Monitor accounts receivable aging and follow up on outstanding balances and claims.
- Maintain accurate resident, payer, and insurance information (census management).
- Coordinate with Health Services and other departments to obtain information necessary for accurate and timely billing.
- Reconcile billing and accounts receivable activity to the general ledger.
- Maintain compliance with Medicare requirements, HIPAA, and KCC policies.
- Assist with Medicare cost-report information, audit schedules, budgeting, and other reimbursement-related reporting.
- Participate in implementation and optimization of KCC's resident billing, EHR, and payment systems.
- Identify opportunities to streamline and automate billing processes while maintaining strong financial controls.
- Provide back-up support within the Finance department as needed.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
