Remote Skilled-Nursing Insurance Billing Specialist

Encore at Wilmington; Bellefonte (DE); Remote; USD 3,637,000 - 5,180,000; Part time

Job summary

Encore at Wilmington seeks a highly experienced Part-Time Insurance Billing Specialist to manage third-party billing for Encore Parkside, Encore Wilmington, and Encore at Foulk. The role covers Medicare Part A/B, Delaware Medicaid, Medicare Advantage, managed care, and commercial plans, with emphasis on accurate, timely submissions and denial resolution.

The ideal candidate will work independently, collaborate with Business Office Managers and leadership, and ensure compliance with HIPAA and

Qualifications

• Minimum five years of healthcare insurance billing experience including skilled-nursing across multiple payer types.
• Ability to independently manage billing and follow-up for multiple facilities and payer types.
• Proven experience resolving complex claim issues, denials, and appeals.
• Experience with PointClickCare billing and Medicaid payer portals is highly desirable.

Responsibilities

• Manage the complete billing cycle for third-party payers across three Delaware communities.
• Review census, payer setup, eligibility, rates, and documentation before claims are generated.
• Prepare, scrub, and submit claims within filing requirements and resolve rejections promptly.
• Investigate unpaid or denied claims and submit corrected claims or appeals.
• Monitor AR aging and provide status updates and action plans for unresolved balances.
• Post or reconcile payments, remittances, adjustments, and contractual balances.

Skills

Healthcare billing

Independent worker

Excellent communication

Education

High school diploma

Billing/coding certification preferred

Tools

PointClickCare

Inovalon

Availity

Novitasphere

Job description

Encore at Wilmington seeks a highly experienced Part-Time Insurance Billing Specialist to manage third-party billing for Encore Parkside, Encore Wilmington, and Encore at Foulk. The role covers Medicare Part A/B, Delaware Medicaid, Medicare Advantage, managed care, and commercial plans, with emphasis on accurate, timely submissions and denial resolution.

The ideal candidate will work independently, collaborate with Business Office Managers and leadership, and ensure compliance with HIPAA and