Corporate 3rd Party Billing Specialist

This position is responsible for the accurate, timely filing, collection, and management of skilled nursing third party billing claims for assigned communities. This position reports to Corporate Revenue Cycle Manager. Additional responsibilities include:

• Third Party Claims submission
  • Medicare A & B
  • Managed Care
  • Third Party Coinsurance
• Maintain documentation to support third party claims submission and collections in accordance with defined policies.
• Prepare documentation/collection notes for monthly accounts receivable reviews.
• Identify, document, and communicate best practices and process improvement opportunities to manager.
• Prepare documentation for approval of contractual allowance adjustments and bad debt write offs
• Attend (in person or via conference call) and participate in monthly Medicare Triple Check meetings validating all required information for claims billing and additional meetings as required
• Maintain up-to-date technical knowledge of Medicare billing rules and regulations via the CMS website, MAC website, newsletters, etc.
• Maintain ongoing metrics for manager, to provide continual self-assessment of performance and identification of process improvement opportunities.
• Provide back-up and cross-training to other associates in the revenue cycle team.
• Coordinate with Revenue Cycle Manager to develop, document and implement processes and procedures related to third party billing.
• Provide additional assistance and support as needed in the revenue cycle function.

To be successful in this role, you would have the following qualifications:

• Bachelor’s Degree in Accounting or Business or equivalent experience.
• 5+ years of 3rd party billing experience handling complex billing issues and strong knowledge of applicable industry regulations.
• Experience with skilled nursing billing is required.
• Experience with Pennsylvania Medicaid is preferred

What's in it for you?

As the largest nonprofit owner/operator of senior living communities in California and one of the largest in the country, we are more than just a place to work. We are here to ensure that all we serve are provided with every opportunity to become their best selves as they define it, and this begins with YOU.

At HumanGood, we offer the opportunity to be part of something bigger than yourself on top of an incredible package of benefits and perks for our part-time and full-time Team Members that can add up to 40% of your base pay.

Full-Time Team Members:

• 20 days of paid time off, plus 7 company holidays (increases with years of service)
• 401(k) with up to 4% employer match and no waiting on funds to vest
• Health, Dental and Vision Plans- start the 1st of the month following your start date
• $25+Tax per line Cell Phone Plan
• Tuition Reimbursement
• 5-star employer-paid employee assistance program
• Find additional benefits at www.HGcareers.org

Compensation: $85,000-95,000 depending on experience and location

Location: this position is mainly remote with occasional office or community visits. Candidates must be located in a state in which HumanGood operates; preferred locations are the greater Philadelphia, Los Angeles, or San Francisco areas.

Come see what HumanGood has to offer!

Equal Opportunity Employer
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