Billing Specialist (Medicare/Managed Care)

EW Admin Services; Buffalo (NY); On-site; USD 26,000 - 34,000; Full time

Benefits offered by this job

Health, dental and vision insurance

401(k) with match

Paid time off and holidays

Free parking at our downtown Buffalo?

Mon-Fri daytime schedule 8:00 am - 4::

Job summary

Elderwood Administrative Services in Buffalo, NY seeks a Billing Specialist (Medicare/Managed Care) to manage Medicare and managed care claims. This full-time, onsite role supports our central billing team at 500 Seneca St.

and interacts with providers, residents, and carriers to ensure timely reimbursement. Key duties include submitting claims, reviewing remittances, resolving denials, and maintaining documentation in PCC.

Qualifications

• High school diploma with 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 detail orientation in a fast-paced environment.

Responsibilities

• Prepare and electronically submit managed care, Medicare Part A, Part B and other 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 productivity.

Skills

Verbal communication

Written communication

Organizational skills

Attention to detail

Fast-paced environment

Education

High school diploma with business training

Tools

Microsoft Office

Job description

Billing Specialist (Medicare/Managed Care)

Salary: $19.00 - 25.00 / Hour

Position Type: Regular Full-Time

Location: Elderwood Administrative Services, Buffalo, NY (500 Seneca St.)

Overview

Medical Billing Specialist - Medicare & Managed Care

Full-Time, Onsite - Buffalo, NY (500 Seneca St.)

Put your Medicare billing experience to work, and see the impact every day.

Elderwood is a family of skilled nursing, rehab and assisted living communities across New York, Vermont and Massachusetts. Our central billing team in Buffalo keeps those communities financially healthy so they can focus on resident care. We're looking for a detail-oriented Medical Billing Specialist who knows Medicare and managed care claims and likes seeing an account through to payment.

Why you'll like working here

• Monday-Friday daytime schedule. No nights, weekends or holidays; Monday-Friday, [8:00 am - 4:30 pm]
• Pay of $19-$25/hour, with more for strong Medicare and managed care experience
• Health, dental and vision insurance
• 401(k) with match
• Paid time off and holidays
• Free parking at our downtown Buffalo office

Employee Perks!

• 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

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.

Qualifications

• 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.

EOE Statement

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.