Billing Specialist (Medicare/Managed Care)

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

Benefits offered by this job

401K with company match

Free on-site parking

Health/dental/vision insurance

Generous PTO & holidays

Life insurance

Job summary

Elderwood Administrative Services is seeking an experienced Medicare and Managed Care Billing Specialist to support accurate electronic claim submission and timely resolution of healthcare claims in Buffalo, NY. This role focuses on payer requirements, follow-up on accounts receivable, remittance review, denials and appeals, and collaboration with managed care organizations and internal teams.

The position is full-time and onsite, with responsibilities that include submitting a wide range of

Qualifications

• High school diploma with basic business training and typing
• Experience with electronic claim submission and follow up
• Proficiency in Microsoft Office
• Excellent verbal and written communication
• Strong organization and attention to detail in a fast-paced environment
• Ability to read, write, and understand English at an intermediate level

Responsibilities

• Prepare and electronically submit managed care, commercial, Medicare Part A/B and other third-party claims
• Review remittances for denials and payment discrepancies
• Investigate and follow up on outstanding claims over 30 days
• Generate and review accounts receivable aging reports
• Contact insurers to confirm claim status and support reimbursement
• Prepare corrected claims and billing adjustments
• Prepare Medicare demand bills and no-pay claims as assigned
• Monitor denials and coordinate with teams for timely appeals
• Document collection activity in PCC Collections
• Apply payer contract requirements during review
• Maintain current payer contracts and billing resources
• Respond to billing and payment inquiries promptly

Skills

Electronic claims submission

Microsoft Office

Communication skills

Organizational skills

Education

High school diploma

Tools

PCC Collections module

Job description

Salary

$19.00 - 25.00 / Hour

Overview

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.

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
• Vision insurance

Responsibilities

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.

Qualifications

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.

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.