Managed Care Billing Specialist

23 hours ago


Montgomery, Alabama, United States Capitol Hill Healthcare Full time
Job Summary

The Managed Care Biller is responsible for managing the billing and accounts receivable process for residents covered by managed care plans within our Skilled Nursing Facility.

Key Responsibilities
  • Submit accurate and timely claims to managed care organizations for services provided to residents.
  • Verify that all necessary documentation and authorizations are in place before claim submission.
  • Verify and obtain pre-authorizations for services covered by managed care plans.
  • Communicate with managed care organizations to ensure authorization requirements are met.
  • Reconcile payments received from managed care organizations with billed amounts.
  • Investigate and resolve discrepancies in payments and denials.
  • Monitor and manage accounts receivable for residents covered by managed care plans.
  • Follow up on overdue payments, denials, and underpayments.
  • Address billing inquiries and payment-related concerns from managed care organizations.
  • Collaborate with the managed care organization's billing and claims departments as needed.
  • Prepare and maintain accurate records of managed care billing and collections.
  • Generate reports on accounts receivable and billing performance for managed care plans.
Requirements
  • High school diploma or equivalent; additional education in Finance, Accounting, or a related field is a plus.
  • Previous experience in billing, accounts receivable, or a related financial role, preferably in a healthcare setting with managed care billing.

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