Medicare & Third-Party Billing Manager - Senior Care

Presbyterian Communities of South Carolina; Summerville (SC); On-site; USD 65,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid time off (PTO)

Retirement savings plan with company参加

Life and disability insurance

Employee assistance program (EAP)

Continuing education and professional 

Career advancement opportunities

Job summary

Presbyterian Communities of South Carolina seeks an experienced Third-Party Billing Manager to oversee Medicare/Managed Care billing for six communities. You will manage claims submission, monitor reimbursements, and ensure regulatory compliance to support resident care.

This role reports to the Senior Billing Manager and requires attention to detail, analytical thinking, and strong communication with insurance carriers and internal teams to optimize revenue cycle performance.

Qualifications

• Associate degree or five years of experience in a skilled nursing facility billing office.
• Minimum of two years of Medicare billing experience in a long-term care setting.
• Working knowledge of Medicare billing regulations and reimbursement practices.

Responsibilities

• Prepare, review, and submit Medicare and Managed Care claims.
• Import and process electronic billing files and ancillary charges, including pharmacy, laboratory, therapy, and medical supplies.
• Submit and monitor coinsurance and crossover claims.
• Research, correct, and resubmit denied or rejected claims.
• Post third-party payments and process contractual adjustments.
• Review aging reports and follow up on outstanding claims and balances.

Skills

Medicare billing

Attention to detail

Communication

Excel

Regulatory compliance

Education

Associate degree

Five years of SNF billing experience

Tools

PointClickCare

Job description

Presbyterian Communities of South Carolina seeks an experienced Third-Party Billing Manager to oversee Medicare/Managed Care billing for six communities. You will manage claims submission, monitor reimbursements, and ensure regulatory compliance to support resident care.

This role reports to the Senior Billing Manager and requires attention to detail, analytical thinking, and strong communication with insurance carriers and internal teams to optimize revenue cycle performance.