Billing Specialist (Medicare/Managed Care)

Elderwood•Buffalo, NY

1d•Onsite

About The Position

Elderwood Administrative Services is seeking an experienced Medicare and Managed Care Billing Specialist to support accurate electronic claim submission and timely resolution of outstanding healthcare claims. The role focuses on electronic claims, payer requirements, accounts receivable follow-up, remittance review, denials, and appeals. The specialist works with managed care organizations, insurance companies, and internal teams to resolve payment issues and support the revenue cycle. This is a full-time, fully onsite position in Buffalo, NY.

Requirements

High school diploma with some business training, including typing and bookkeeping.
Experience with electronic claim submission and follow-up.
Experience with Microsoft Office.
Excellent verbal and written communication skills.
Strong organization and attention to detail, with the ability to work in a fast-paced environment.
Knowledge of office machines and computer equipment.
Ability to perform tasks to established standards of excellence.
Ability to read, write, speak, and understand English 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 weekly or biweekly.
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 to improve the quality of care for residents or increase job productivity and satisfaction.