Remote Skilled Nursing Insurance Billing Specialist

Encore HCS; Bellefonte (DE); Remote; USD 34,000 - 55,000; Part time

Job summary

Encore HCS seeks a highly experienced Part-Time Insurance Billing Specialist to manage third-party billing for Encore Parkside, Encore Wilmington, and Encore at Foulk in Delaware.

The role covers Medicare, Medicaid, Medicare Advantage, managed care, and commercial plans, focusing on accurate, timely claim submission, AR follow-up, denial resolution, and payer reconciliation. Remote work with minimal supervision is expected.

Qualifications

• Minimum five years of healthcare insurance billing experience across multiple payer types.
• Proven ability to independently manage billing and follow-up for multiple facilities.

Responsibilities

• Manage the complete billing cycle for third-party payers across three Delaware communities (Medicare Part A/B, Medicaid, Medicare Advantage, managed care, commercial).
• Review census, payer setup, authorizations, eligibility, rates, revenue codes, and supporting documents before claims.
• Prepare, scrub, and submit accurate claims within filing requirements; resolve edits and submission errors promptly.
• Investigate unpaid/denied claims; submit corrected claims or appeals and document follow-up through resolution.
• Perform AR aging management, prioritizing high-dollar/timely filing risks, with status updates and action plans.
• Post or reconcile insurance payments, remittances, adjustments, and contractual balances.
• Complete month-end billing tasks and reconcile census, claims, payments, and balances.
• Maintain payer portal access and use PointClickCare, Inovalon, Availity, Novitasphere, Medicaid portals.
• Collaborate with Business Office Managers, Admissions, MDS, Nursing, Therapy, Medical Records and leadership to resolve barriers.
• Participate in aging and revenue-cycle meetings; report risks and necessary corrections.
• Monitor payer rule changes and ensure HIPAA and internal policies compliance.

Skills

Attention to detail

Independent worker

Strong communication

Analytical problem solving

Education

High school diploma or equivalent

Associate degree or billing/coding certification preferred

Tools

PointClickCare

Inovalon

Availity

Novitasphere

Medicaid payer portals

Job description

Encore HCS seeks a highly experienced Part-Time Insurance Billing Specialist to manage third-party billing for Encore Parkside, Encore Wilmington, and Encore at Foulk in Delaware.

The role covers Medicare, Medicaid, Medicare Advantage, managed care, and commercial plans, focusing on accurate, timely claim submission, AR follow-up, denial resolution, and payer reconciliation. Remote work with minimal supervision is expected.