Healthcare Billing & AR Specialist (Medicaid)

Pendleton Manor, Inc.; Franklin (WV); On-site; USD 34,000 - 41,000; Full time

Job summary

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.

Qualifications

• 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

Responsibilities

• 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

Skills

Attention to detail

Deadline management

Healthcare billing

Communication skills

Job description

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.