Managed Care Biller

Rockport Healthcare Services; Glendale (CA); On-site; USD 60,000 - 90,000; Full time

Job summary

Rockport Healthcare Services is seeking a billing professional with strong experience in managed care within a skilled nursing facility environment. The role focuses on submitting claims, ensuring required information, and maintaining timely cash flow through diligent follow-up and denial management.

The ideal candidate will review aging reports monthly, coordinate authorizations, and validate documentation before submission to minimize denials and maximize payments.

Qualifications

• 5+ years of managed care billing experience in a skilled nursing facility environment.
• Experience with third-party payer submissions and denials management.
• Ability to review claims for completeness, timeliness, and accuracy.

Responsibilities

• Submit reimbursement claims to third parties for services rendered.
• Review claims for required information and format before submission.
• Ensure timely submission to maintain cash flow and minimize denials.
• Follow up on claims and confirm receipt by payers; verify electronic and hard copy submissions.
• Coordinate receipt of authorizations and maintain weekly logs for missing approvals.
• Validate supporting documentation prior to submission (authorization, census data, etc.).
• Review aging reports monthly and perform follow-up on unpaid accounts.

Skills

Managed Care Billing

SNF Billing

Accounts Receivable

Job description

Essential Job Functions:

1. Submits reimbursement claims to third parties (insurance health plans, government agencies, etc.) for services rendered at assigned facilities.


2. Ensures claims have the required information in the specified format. Reviews claims for errors prior to submission.


3. Submits claims within the required timeframes to ensure consistent cash flow and reduce risk of technical denials for untimely filing.


4. Follows up on claims to ensure third party or government agency received the claim:
   
   
   
   1. Electronic billing verification no less than 48-hours after claim submission
   
   
   2. Hard copy billing no less than 14 days after claim mailed
   
   
   
   


5. Coordinates receipt of insurance authorization with facility and maintains missing authorization log no less than weekly.


6. Validates supporting documentation prior to submitting the claim including but not limited to balanced census, triple check, authorization, etc.


7. Reviews aging no less than monthly and identifies unpaid accounts. Completes follow-up on all unpaid accounts monthly.

Qualifications:

5 Years Managed Care Billing Experience in a SNF environment