Billing Specialist

Overview

Catholic Eldercare is seeking a detail-oriented, compassionate, and experienced Billing Specialist to join our team. In this role, you will focus primarily on managing private pay (self-pay) and resident resource (Medicaid) revenue cycle, ensuring accurate monthly invoicing, tracking resident accounts receivable, and coordinating closely with residents and their families. The ideal candidate possesses a strong background in healthcare paired with exceptional customer service and empathy.

The Billing Specialist reports to the Controller and is a part of the Business Office. This position works in office 5 days per week, with the ability to work in office 3-4 days per week after a training period.

This role offers a unique opportunity to work on a small team and be involved in a broad range of responsibilities in the business office, including interacting with residents and families.

The Billing Specialist will:

• Generate and distribute accurate monthly private pay and resident resource statements for room and board, and ancillary care services in a timely manner.
• Process payments for private pay and all other payers received via check, automatic withdrawal or EFT, and post to resident accounts in billing software.
• Monitor aging reports specifically for private pay accounts to identify overdue balances and delinquent accounts. Escalating severe, delinquent accounts or collections challenges to the Controller.
• Communicate empathetically yet firmly with residents, families or responsible parties regarding past-due balances and payment expectations. Assist in setting up structured and realistic payment arrangements when necessary.
• Serve as the primary point of contact for resident families regarding billing inquiries, statement clarifications and other questions.
• Work closely and coordinate with social services regarding changes in financial status, such as transitions from private pay to Medicaid or other matters involving billing.
• Partner with the third-party biller on matters related to insurance verification, authorizations and denials as well as insurance payment application.
• Elderly Waiver Billing for Housing communities – work with the Executive Directors to submit claims, obtain necessary authorizations, investigate and resolve denied or rejected claims.
• Record Keeping and Reporting – Maintain accurate records of billing information, resident data, and financial transactions.
• Prepare routine aging reports, collections summaries and other reporting for leadership.
• Compliance and Regulatory Adherence – Ensure compliance with all relevant billing regulations, including HIPAA and payer-specific guidelines.
• Communication and Customer Service – Effectively communicate with insurance companies, residents and their families, and other stakeholders regarding billing inquiries and issues.

REQUIRED QUALIFICATIONS:

• High School Diploma
• 2-3 years of billing or accounts receivable experience, preferably within a skilled nursing facility
• Technical
  
  Skills:
  
  Proficiency in using billing software, electronic health record (EHR) systems, Microsoft Office applications (Word, Excel, Teams) and other relevant tools.
• Organizational
  
  Skills:
  
  Ability to manage multiple tasks/projects, prioritize effectively and meet deadlines.
• Attention to detail:
  Accuracy in data entry, coding and claim preparation.
• Critical Thinking
  
  Skills:
  
  Ability to identify and resolve billing discrepancies and denials.
• Communication
  
  Skills:
  
  Exceptional communication and active listening skills, with a high degree of tact, patience, and empathy when dealing with residents and families.
• Work as a team member and adapt to changes in work assignments to meet resident and/or staffing needs.
• Regulatory Knowledge:
  Solic understanding of HIPAA compliance

PREFERRED QUALIFICATIONS

• Associate’s degree or higher in accounting, finance or healthcare administration preferred.
• Skilled Nursing billing experience highly preferred.
• Detailed knowledge of Medicare, Medicaid and third-party reimbursement policies preferred.
• Matrix Care experience preferred.

SKILLS AND ABILITIES

• Ability to manage multiple tasks/projects, prioritize effectively, and meet deadlines.
• Att…