Billing Specialist (Medicare/Managed Care)

Elderwood•Buffalo, NY

10d•Onsite

About The Position

Elderwood Administrative Services is seeking an experienced Medicare and Managed Care Billing Specialist to support accurate electronic claim submission and the timely resolution of outstanding healthcare claims. This position is well suited for a detail-oriented billing professional who understands electronic claims, payer requirements, accounts receivable follow-up, remittance review, denials and appeals. You will work closely with managed care organizations, insurance companies and internal teams to resolve payment issues and help maintain a healthy revenue cycle. This is a full-time, fully onsite position. Effective billing follow-up directly supports the financial health of Elderwood’s care communities. In this role, you will help identify reimbursement issues, reduce aging balances and ensure that claims are handled accurately and consistently. If you have healthcare billing experience and enjoy investigating claims, resolving discrepancies and seeing accounts through to completion, we encourage you to apply today!

Requirements

High school diploma with some business training, including typing and bookkeeping required.
Experience with electronic claim submission and follow up required.
Experience with Microsoft Office.
Excellent verbal and written communication skills.
Strong organization and detail-orientation and ability to work in a fast-paced environment.
Knowledge of the use of office machines and computer equipment.
Ability to perform tasks to established standards of excellence.
This position requires regular interaction with residents, coworkers, visitors, and/or supervisors.
In order to ensure a safe work environment for residents, coworkers, visitors, and/or supervisors of the Company, and to permit unfettered communication between the employee and those residents, coworkers, visitors, and supervisors, this position requires that the employee be able to read, write, speak, and understand the English language at an intermediate or more advanced level.

Responsibilities

Prepare and electronically submit managed care, commercial insurance, Medicare Part A, Medicare Part B and other assigned third-party claims
Review remittances for denials, payment discrepancies, copayments and deductibles
Investigate and follow up on outstanding claims over 30 days until payment or final resolution
Generate and review accounts receivable aging reports on a weekly or biweekly basis
Contact insurance carriers and managed care organizations to confirm claim status and support timely reimbursement
Prepare and submit corrected claims, rebills, billing adjustments and other assigned claim types
Prepare Medicare demand bills, informational claims, discharge claims and no-pay claims as assigned
Monitor claim denials and coordinate with facility and regional teams to support timely appeals
Maintain accurate documentation of collection activity in the PCC Collections module
Apply managed care and insurance contract requirements when reviewing reimbursement and billing issues
Help maintain current payer contracts, provider manuals and related billing resources
Respond promptly and professionally to billing and payment inquiries
Prepare recommended bad-debt write-offs for review by the Director of Accounts Receivable
Generate and develop ideas, which improve the quality of care for residents or increase job productivity and satisfaction.