Medicare & Managed Care Billing Specialist

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

Benefits offered by this job

Health, dental and vision insurance

401(k) with match

Paid time off and holidays

Free parking at our downtown Buffalo?

Mon-Fri daytime schedule 8:00 am - 4::

Job summary

Elderwood Administrative Services in Buffalo, NY seeks a Billing Specialist (Medicare/Managed Care) to manage Medicare and managed care claims. This full-time, onsite role supports our central billing team at 500 Seneca St.

and interacts with providers, residents, and carriers to ensure timely reimbursement. Key duties include submitting claims, reviewing remittances, resolving denials, and maintaining documentation in PCC.

Qualifications

• High school diploma with business training including typing and bookkeeping.
• Experience with electronic claim submission and follow up.
• Experience with Microsoft Office.
• Excellent verbal and written communication skills.
• Strong organization and detail orientation in a fast-paced environment.

Responsibilities

• Prepare and electronically submit managed care, Medicare Part A, Part B and other 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 weekly or biweekly.
• 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 to improve the quality of care for residents or increase productivity.

Skills

Verbal communication

Written communication

Organizational skills

Attention to detail

Fast-paced environment

Education

High school diploma with business training

Tools

Microsoft Office

Job description

Elderwood Administrative Services in Buffalo, NY seeks a Billing Specialist (Medicare/Managed Care) to manage Medicare and managed care claims. This full-time, onsite role supports our central billing team at 500 Seneca St.

and interacts with providers, residents, and carriers to ensure timely reimbursement. Key duties include submitting claims, reviewing remittances, resolving denials, and maintaining documentation in PCC.