Corporate Managed Care Specialist

Ryders Health Management, Inc; Stratford, Northern (CT, KY); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

401(k) retirement plan

Paid Time Off (PTO)

Employee Assistance Program (EAP)

Job summary

Ryders Health Management, Inc is looking for a Corporate Managed Care Specialist in Stratford, CT. The role involves managing claims and reimbursement for skilled nursing facilities, ensuring compliance with payer guidelines. Candidates should have at least 2 years of experience in SNF billing and a strong understanding of Medicare and managed care. Proficiency in PointClickCare is required. A comprehensive benefits package is offered including medical insurance, 401(k), and paid time off.

Qualifications

• Minimum 2+ years of experience in Skilled Nursing Facility billing.
• Strong knowledge of Medicare Advantage and commercial insurance payers.
• Experience in handling billing trends and reimbursement processes.

Responsibilities

• Manage and submit Managed Care claims for Skilled Nursing Facilities.
• Follow up on unpaid claims and authorization issues.
• Coordinate with various facility departments for accurate billing.

Skills

Managed Care billing

Skilled Nursing Facility (SNF) billing

Microsoft Office proficiency

Communication skills

Organizational skills

Problem-solving skills

Tools

PointClickCare (PCC)

Inovalon

Job description

LOCATION: Stratford, CT

POSITION TYPE: Full-Time, 40-hours

SHIFT(S): 40-hours per week, days, M-F

PAY RANGE: $70,000 - $100,000

BENEFITS – Full-Time:

• Medical, Dental, and Vision Insurance (for employee ± dependents)
• 401(k) retirement plan (with employer match or contribution)
• Employer-Paid Life Insurance
• Short- and Long-Term Disability (as applicable)
• Paid Meal Period
• Paid Time Off (PTO) — vacation, personal days, sick time
• 8 Paid Holidays
• Holiday and Overtime Pay (as per facility policy)
• Employee Assistance Program (EAP)
• Employee Discounts
• Paid Training and Orientation
• Uniform Allowance
• Longevity Awards

JOB SUMMARY

Are you an experienced Managed Care and Skilled Nursing billing professional with a strong understanding of revenue cycle operations and reimbursement management? We are seeking a Corporate Managed Care Specialist to support our skilled nursing facilities with managed care billing, collections, authorization follow-up, and reimbursement processes across a multi-facility portfolio.

This role plays a critical part in supporting financial performance and ensuring timely reimbursement by managing payer relationships, resolving claims issues, and collaborating closely with facility and corporate teams. The ideal candidate will thrive in a fast-paced healthcare environment and demonstrate strong organizational, analytical, and follow-up skills.

RESPONSIBILITIES

• Submit and manage Managed Care claims for Skilled Nursing Facilities (SNFs)
• Follow up on unpaid claims, denials, underpayments, and authorization issues
• Review eligibility, authorization status, and payer requirements to ensure accurate billing and reimbursement
• Work aging reports and maintain timely and accurate follow-up documentation
• Coordinate with facility Business Office Managers (BOMs), therapy departments, MDS teams, and centralized billing teams
• Identify billing trends and elevate reimbursement concerns appropriately
• Assist with payer reconciliations and revenue cycle cleanup projects
• Maintain compliance with payer guidelines, billing regulations, and company processes
• Support revenue cycle improvement initiatives and assist with resolving complex reimbursement issues
• Provide regular updates regarding claims status, collections activity, and reimbursement trends

QUALIFICATIONS

• Minimum 2+ years of Skilled Nursing Facility (SNF) billing experience required
• Managed Care billing and collections experience strongly preferred
• Knowledge of Medicare Advantage and commercial insurance payers
• Experience with PointClickCare (PCC) required
• Experience with Inovalon preferred
• Strong understanding of SNF claims, authorizations, eligibility verification, and collections workflows
• Ability to manage multiple facilities and competing priorities simultaneously
• Strong communication, organizational, and problem‑solving skills
• Proficiency with Microsoft Office (Word, Excel, Outlook) and healthcare billing systems
• Must be able to read, write, and communicate effectively in English.

PREFERRED QUALIFICATIONS

• Experience supporting multi‑facility skilled nursing or long‑term care operations
• Knowledge of managed care reimbursement trends and payer regulations
• Experience with revenue cycle reporting and reconciliation processes

EQUAL OPPORTUNITY EMPLOYER STATEMENT

We are an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law.