Strategic Managed Care Billing Specialist (SNF)

Ryders Health Management; Johnsons Corner (CT); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Medical, Dental, and Vision Insurance

401(k) retirement plan

Employer-Paid Life Insurance

Short- and Long-Term Disability

Paid Meal Period

Paid Time Off (PTO)

8 Paid Holidays

Holiday and Overtime Pay

Employee Assistance Program (EAP)

Employee Discounts

Paid Training and Orientation

Uniform Allowance

Longevity Awards

Job summary

Ryders Health Management in Stratford, CT is seeking a Corporate Managed Care Specialist to support Skilled Nursing Facilities with managed care billing, authorizations, and reimbursement processes across multiple facilities. This role drives timely reimbursement and accurate revenue cycle activities within a fast-paced healthcare environment.

The ideal candidate will have 2+ years SNF billing experience, knowledge of Medicare Advantage and commercial payers, and experience with PCC.

Qualifications

• Minimum 2+ years of SNF billing experience required.
• Managed Care billing and collections experience preferred.
• Knowledge of Medicare Advantage and commercial insurance payers.
• Experience with PCC (PointClickCare) required.
• Strong understanding of SNF claims, authorizations, eligibility verification, and collections workflows.
• Must read, write, and communicate effectively in English.

Responsibilities

• Submit and manage Managed Care claims for Skilled Nursing Facilities (SNFs).
• Follow up on unpaid claims, denials, underpayments, and authorization issues.
• Review eligibility, authorization status, and payer requirements to ensure accurate billing and reimbursement.
• Work aging reports and maintain timely and accurate follow-up documentation.
• Coordinate with facility Business Office Managers (BOMs), therapy departments, MDS teams, and centralized billing teams.
• Identify billing trends and escalation reimbursement concerns appropriately.
• Assist with payer reconciliations and revenue cycle cleanup projects.
• Maintain compliance with payer guidelines, billing regulations, and company processes.
• Support revenue cycle improvement initiatives and assist with resolving complex reimbursement issues.
• Provide regular updates regarding claims status, collections activity, and reimbursement trends.

Skills

SNF billing

Managed care billing

Medicare Advantage knowledge

Authorizations & eligibility

English communication

Multi-facility management

Problem-solving

Organizational skills

Tools

PointClickCare (PCC)

Inovalon

Microsoft Office

Job description

Ryders Health Management in Stratford, CT is seeking a Corporate Managed Care Specialist to support Skilled Nursing Facilities with managed care billing, authorizations, and reimbursement processes across multiple facilities. This role drives timely reimbursement and accurate revenue cycle activities within a fast-paced healthcare environment.

The ideal candidate will have 2+ years SNF billing experience, knowledge of Medicare Advantage and commercial payers, and experience with PCC.