Strategic SNF Managed Care Billing Specialist

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

Benefits offered by this job

Health insurance

Retirement plan with employer match

Life insurance

Disability benefits

Paid meal breaks

PTO

Holidays

Overtime pay

EAP

Employee discounts

Training & orientation

Uniform allowance

Longevity awards

Job summary

Ryders Health Management in Connecticut is seeking a Corporate Managed Care Specialist to support our skilled nursing facilities with managed care billing, collections, authorizations, and reimbursement processes across a multi-facility portfolio.

This role plays a critical part in optimizing revenue cycle, collaborating with facility BOMs, therapy, MDS, and centralized billing teams to ensure timely reimbursement.

Qualifications

• Minimum 2+ years of SNF billing experience.
• Experience with managed care billing and collections is strongly preferred.
• Knowledge of Medicare Advantage and commercial payers.
• Proficiency with PointClickCare (PCC) required.
• Experience with Inovalon preferred.
• Understanding SNF claims, authorizations, eligibility verification, and collections workflows.
• Ability to manage multiple facilities and competing priorities.
• Strong communication and problem-solving skills.
• Proficiency with Microsoft Office and healthcare billing systems.
• English reading and writing communication required.

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 elevate 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

Skilled Nursing Facility billing

Managed Care billing

Payer communications

PCC (PointClickCare)

Inovalon

SNF claims & authorizations

Multiple facility management

Communication & organization

MS Office (Word/Excel/Outlook)

English proficiency

Tools

PointClickCare (PCC)

Inovalon

Job description

Ryders Health Management in Connecticut is seeking a Corporate Managed Care Specialist to support our skilled nursing facilities with managed care billing, collections, authorizations, and reimbursement processes across a multi-facility portfolio.

This role plays a critical part in optimizing revenue cycle, collaborating with facility BOMs, therapy, MDS, and centralized billing teams to ensure timely reimbursement.