Third Party Billing Manager - Full Time
About The Position
Presbyterian Communities of South Carolina is seeking an experienced Third-Party Billing Manager to oversee third-party billing, claims management, and reimbursement processes for our six communities. This role is ideal for a detail-oriented professional with a strong understanding of Medicare billing and long-term care reimbursement. Reporting directly to the Senior Billing Manager, the Third-Party Billing Manager plays a critical role in ensuring accurate claim submission, timely reimbursement, regulatory compliance, and exceptional service to our residents and communities.
Requirements
- Associate degree or five years of experience in a skilled nursing facility billing office
- Minimum of two years of Medicare billing experience in a long-term care setting
- Working knowledge of Medicare billing regulations and reimbursement practices
- Intermediate Microsoft Excel skills
- Strong attention to detail and problem-solving abilities
- Excellent communication and organizational skills
Nice To Haves
- Point Click Care experience
- Highly organized and deadline-driven
- Analytical and accurate in their work
- Proactive in identifying and resolving billing issues
- Committed to exceptional customer service
- Collaborative and team-oriented
- Able to manage multiple priorities while maintaining compliance and quality standards
Responsibilities
- Prepare, review, and submit Medicare and Managed Care claims
- Import and process electronic billing files and ancillary charges, including pharmacy, laboratory, therapy, and medical supplies
- Submit and monitor coinsurance and crossover claims
- Research, correct, and resubmit denied or rejected claims
- Post third-party payments and process contractual adjustments
- Review aging reports and follow up on outstanding claims and balances
- Communicate with insurance carriers regarding unpaid claims over 30 days old
- Participate in Triple Check meetings and support revenue cycle compliance
- Maintain accurate billing records and monthly reporting
- Assist with claim audits and reimbursement reviews
- Coordinate with Accounts Payable regarding Medicare-related vendor invoices
- Serve as a system administrator for payer portals, including Palmetto GBA and other third-party billing systems
- Stay current on Medicare regulations and reimbursement changes through ongoing education
Benefits
- Competitive salary based on experience
- Medical, dental, and vision insurance
- Paid time off (PTO)
- Retirement savings plan with company participation
- Life and disability insurance
- Employee assistance program (EAP)
- Continuing education and professional development opportunities
- Supportive leadership and team environment
- Opportunities for career advancement within a growing organization
- Meaningful work that directly supports quality care for seniors
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
