Third Party Billing Manager - Full Time

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

Third Party Billing Manager

Join our team and make a difference in senior care!

Description

Third Party Billing Manager

Join our team and make a difference in senior care!

Presbyterian Communities of South Carolina is seeking an experienced Third-Party Billing Manager to oversee third-party billing, claims management, and reimbursement processes for our six communities. This role is ideal for a detail-oriented professional with a strong understanding of Medicare billing and long-term care reimbursement.

Reporting directly to the Senior Billing Manager, the Third-Party Billing Manager plays a critical role in ensuring accurate claim submission, timely reimbursement, regulatory compliance, and exceptional service to our residents and communities.

What You\'ll Do

As our Third-Party Billing Manager, you will:

• 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


• Communicate with insurance carriers regarding unpaid claims over 30 days old


• Participate in Triple Check meetings and support revenue cycle compliance


• Maintain accurate billing records and monthly reporting


• Assist with claim audits and reimbursement reviews


• Coordinate with Accounts Payable regarding Medicare-related vendor invoices


• Serve as a system administrator for payer portals, including Palmetto GBA and other third-party billing systems


• Stay current on Medicare regulations and reimbursement changes through ongoing education

What We\'re Looking For

• 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


• Intermediate Microsoft Excel skills


• Strong attention to detail and problem-solving abilities


• Excellent communication and organizational skills

The Ideal Candidate Is

• Has Point Click Care experience


• Highly organized and deadline-driven


• Analytical and accurate in their work


• Proactive in identifying and resolving billing issues


• Committed to exceptional customer service


• Collaborative and team-oriented


• Able to manage multiple priorities while maintaining compliance and quality standards

Why Join Our Team?

At PCSC, we believe our employees are our greatest asset. We are committed to supporting our team members through a competitive compensation package, comprehensive benefits, and a mission-driven culture focused on serving others with compassion and excellence.

Competitive Benefits Include

• Competitive salary based on experience


• Medical, dental, and vision insurance


• Paid time off (PTO)


• Retirement savings plan with company participation


• Life and disability insurance


• Employee assistance program (EAP)


• Continuing education and professional development opportunities


• Supportive leadership and team environment


• Opportunities for career advancement within a growing organization


• Meaningful work that directly supports quality care for seniors

Our Culture

At PCSC, our mission is rooted in compassionate Christian service. We strive to create a workplace where employees feel valued, respected, and empowered to make a difference. We are looking for professionals who share our commitment to relationships, teamwork, excellence, stewardship, and service.

EOE