Billing Specialist (Medicare/Managed Care)

$19.00 - 25.00 / Hour

Medicare & Managed Care Billing Specialist

Elderwood Administrative Services

Full Time - Buffalo, NY

Build Your Healthcare Billing Career with Elderwood

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.

Why This Role Matters

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!

401K Retirement Plan with Company Match, Enjoy being a part of a strong and diverse team, Free On-Site Parking, Friendly and supportive staff, Generous PTO & holiday package, Life Insurance, Medical, Dental, and Vision insurance

What You'll Do as Medical Billing Specialist (Medicare/Managed Care):

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.

What You'll Need as Medical Billing Specialist (Medicare/Managed Care):

• 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.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.