Billing & Coding Specialist

Pendleton Manor; Franklin (WV); Presencial; USD 34 000 - 41 000; Tempo integral

Resumo da oferta

Pendleton Manor, Inc. in Franklin, WV is seeking a detail‑oriented Billing Specialist to manage Medicare, Medicaid, and commercial claims. You will ensure accurate billing, timely submissions, and responsive follow‑up with payers.

The role requires strong attention to detail, excellent communication, and the ability to meet multiple deadlines while safeguarding patient confidentiality and HIPAA compliance. Experience with aged AR and revenue cycle improvements is a plus.

Qualificações

• Firm understanding of the healthcare reimbursement process and payer requirements
• Strong attention to detail and ability to persevere in filing claims and following up on denials
• Ability to meet multiple deadlines consistently and seek help when needed to meet them
• Maintain confidentiality and ensure compliance with HIPAA, federal and state rules
• Proven experience reviewing and managing aged accounts receivable and resolving billing issues
• Ability to collaborate with a billing team and identify process improvements
• Strong analytical, organizational, and problem-solving skills
• Excellent communication, organization, and documentation for customer service

Responsabilidades

• Ensure accurate and timely billing and submission of claims across Medicare, Medicare Advantage, commercial insurance, and Medicaid
• Review aged accounts receivable (AR), identify outstanding balances, and drive timely resolution and collection
• Assist residents and families with Medicaid applications and WV Medicaid spend-down to qualify
• Identify billing discrepancies, reimbursement delays, and potential revenue leakage; coordinate with teams to resolve issues
• Submit and follow up WV Medicaid remedials and WV Medicaid year redeterminations
• Collaborate with internal stakeholders to improve billing workflows, reporting accuracy, and AR performance
• Maintain consistent billing processes and financial reporting across facilities
• Monitor billing performance, trends, discrepancies, and opportunities to improve revenue cycle
• Ensure month-end billing reports and reporting requirements are completed accurately and on time

Conhecimentos

Attention to detail

Deadline management

Healthcare billing

Communication skills

Descrição da oferta de emprego

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Business Office Administrative Franklin, WV, US

Salary Range: $25.00 To $30.00 Hourly

Examples of duties to be performed:

• Ensure accurate and timely billing and submission of claims across Medicare, Medicare Advantage, commercial insurance, and Medicaid


• Review aged accounts receivable (AR), identify outstanding balances, and drive timely resolution and collection. (remittances, contractual adjustments, claim submission, claim resubmission, etc)


• Assisting residents and their families with the complex process of applying for long-term care Medicaid benefits and the process of “spending down” to be eligible for WV Medicaid


• Identify billing discrepancies, reimbursement delays, and potential revenue leakage, working with the appropriate team members to resolve issues.


• Submission & Follow Up of WV Medicaid Remedials & WV Medicaid Year Redeterminations


• Collaborate with internal stakeholders and facility teams to improve billing workflows, reporting accuracy, and overall accounts receivable performance.


• Help maintain consistent billing processes and financial reporting across the facilities supported by the organization.


• Monitor billing performance and identify trends, discrepancies, and opportunities to improve revenue cycle processes.


• Ensure all month-end billing reports and reporting requirements are completed accurately and on time.

Key Position Qualifications Include:

• Must have a firm understanding of the Healthcare reimbursement process, payer requirements and the fundamentals of insurance, including covered services, deductible, co-insurance, WV Medicaid, Long Term Care Insurance, Medicare A and B, and supplemental insurance


• Must have strong attention to detail and be independently driven to persevere in filing claims, and following up on denials


• Ability to meet multiple deadlines consistently and ask for assistance when needed to meet those deadlines.


• Must be able to maintain confidentiality and ensure compliance with HIPPA, federal and state rules and regulations


• Proven experience reviewing and managing aged accounts receivable and resolving outstanding billing issues.


• Ability to work collaboratively with an established billing team while identifying opportunities to improve processes and performance.


• Strong attention to detail and the ability to manage competing priorities in a performance and deadline-driven environment.


• Strong analytical, organizational, and problem-solving skills.


• Excellent communication, organization, and documentation skills providing friendly professional customer service