Managed Care Biller (24797)

Cantex Continuing Care Network; Carrollton (TX); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Competitive pay

Performance-based bonus opportunities

Health, dental, and vision insurance

Supplemental benefits

401(k) with company match

Paid time off

Career growth opportunities

Supportive company culture

Job summary

Cantex Corporate in Carrollton, TX is seeking a Managed Care / Medicare Billing Specialist to oversee accounts receivable, billing, claims processing, and collections across multiple Skilled Nursing Facilities in Texas. This role focuses on optimizing the managed care and Medicare revenue cycle by ensuring accurate claims submission, timely reimbursement, denial resolution, and regulatory compliance.

The Specialist drives cash flow, reduces aging receivables, minimizes denials, and supports

Qualifications

• High school diploma required; college coursework preferred.
• Prior managed care and Medicare billing experience in SNF.
• Strong knowledge of healthcare billing software such as AHT or HealthMEDX Vision.
• Understanding of Medicare Part A billing and long-term care revenue cycle.

Responsibilities

• Process monthly managed care and Medicare Part A claims for multiple SNFs.
• Create, submit, track, and reconcile managed care and Medicare claims.
• Analyze and resolve denied, rejected, or underpaid claims.
• Verify Medicare eligibility, benefit periods, skilled coverage days, and payer requirements.
• Post payments and ensure accurate reimbursement reporting.
• Communicate with providers, facilities, payers, and internal stakeholders regarding billing questions.

Skills

Managed care billing

Medicare billing

Healthcare billing software

Medicare Part A

ICD-9/ICD-10 coding

Analytical / organizational

Team oriented

Communication skills

Education

High school diploma

College degree preferred

Tools

American HealthTech (AHT)

HealthMEDX Vision

Job description

Job Details: Job Location: Cantex Corporate - Carrollton, TX 75006, Position Type: Full Time, Job Category: Finance, Location: Carrollton, TX

Schedule: Full‑time role with standard business hours

Reports to: AR Manager

What We Offer You

• Competitive pay
• Performance‑based bonus opportunities
• Comprehensive health, dental, and vision insurance
• Additional supplemental benefits (life insurance, disability, accident, etc.)
• 401(k) with company match
• Generous paid time off (PTO/Sick)
• Clear career growth and advancement opportunities
• A supportive and vibrant company culture
• Many more employee perks and benefits

Job Summary

The Managed Care / Medicare Billing Specialist is responsible for managing the accounts receivable, billing, claims processing, collections, and reimbursement functions for multiple Skilled Nursing Facilities (SNFs) throughout Texas. This role focuses on optimizing the managed care and Medicare revenue cycle by ensuring accurate claims submission, timely reimbursement, denial resolution, payment posting, and regulatory compliance.

The Managed Care / Medicare Billing Specialist serves as a key contributor to revenue cycle performance by improving cash flow, reducing aging accounts receivable, minimizing claim denials, and supporting overall financial health. This position requires expertise in Medicare Part A billing, managed care billing, insurance claims processing, and long‑term care reimbursement.

Qualifications

• High school diploma required; college degree or equivalent advanced coursework preferred
• Prior managed care and Medicare billing experience in a Skilled Nursing Facility (SNF) environment required
• Strong knowledge of healthcare billing software, including American HealthTech (AHT) and/or HealthMEDX Vision preferred
• Understanding of Medicare Part A billing, managed care billing, reimbursement methodologies, and long‑term care revenue cycle operations
• Knowledge of ICD‑9 and ICD‑10 diagnosis coding principles
• Ability to prioritize workload, manage multiple deadlines, and work efficiently in a fast‑paced environment
• Strong analytical, organizational, customer service, and communication skills
• Team‑oriented mindset with willingness to support other areas of medical billing and accounts receivable

Essential Functions

• Process monthly managed care and Medicare Part A claims for multiple Skilled Nursing Facilities
• Create, submit, track, and reconcile managed care and Medicare claims
• Analyze, research, and resolve denied, rejected, or underpaid claims
• Verify Medicare eligibility, benefit periods, skilled coverage days, and payer requirements
• Post payments and ensure accurate reimbursement reporting
• Communicate with providers, facilities, payers, and internal stakeholders regarding billing questions and claim status
• Ensure all billing is accurate, complete, and compliant with federal, state, Medicare, Medicaid, and payer regulations
• Coordinate third‑party billing activities with facility personnel and operational teams
• Collaborate with fiscal intermediaries, auditors, cost report preparers, state agencies, federal agencies, and commercial insurance carriers
• Monitor accounts receivable balances and maintain aging within established company goals
• Assist with collection efforts and resolution of complex reimbursement issues
• Utilize billing software to improve workflow efficiency, claim accuracy, and revenue cycle performance
• Understand payer transmission requirements and ensure proper electronic claim submissionAnalyze and resolve technical billing issues involving claims processing, resident accounts, reimbursement calculations, and claim transmission errors
• Maintain compliance with all billing regulations, revenue cycle initiatives, and company financial management systems
• Prepare and distribute billing, reimbursement, collection, and accounts receivable reports as requested
• Support company DSO, cash collection, and reimbursement goals through proactive account management
• Perform additional duties and special projects as assigned by the AR Manager, Director of Finance, or CFO

We are an Equal Opportunity Employer. We offer an excellent benefit plan to include 401(k) with match, CEU reimbursement, vacation, sick time, holidays, medical, dental, and supplemental insurance plans, as well as a highly competitive compensation package.

Please visit cantexcc.com for more information about our organization.

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