Senior Revenue Cycle Specialist

The Senior Revenue Cycle Specialist is responsible for managing and optimizing the full accounts receivable cycle across multiple senior living communities, including Independent Living, Assisted Living, Memory Care, and Skilled Nursing. Operating within the Central Billing Office, this role ensures accurate charge creation, compliant billing, timely reimbursement, and disciplined collections practices in accordance with Medicare, Medicaid, Managed Care, and private pay requirements.

This position plays a critical role in protecting revenue integrity, reducing days in AR, and maintaining financial compliance across a multi-state portfolio.

Key Responsibilities

Accounts Receivable Management

• Manage a portfolio of resident accounts across multiple communities and states

• Monitor aging reports and proactively reduce Days in AR and bad debt exposure

• Identify trends in denials, underpayments, and billing discrepancies

• Complete month-end closing procedures and AR reporting accurately and timely

• Generate and distribute resident statements

• Respond to account inquiries from residents, families, and community staff

• Post payments accurately within established timelines

Charge Capture & Billing Accuracy

• Create and validate charges for Private Pay, Medicaid, Medicare, and Managed Care plans

• Ensure charges reflect services rendered and are posted within required deadlines

• Collaborate with community and clinical teams to verify census and level-of-care changes

• Audit charges for accuracy prior to claim submission and month-end close

Medicare, Medicaid & Managed Care Oversight

• Ensure clean claim submission by maintaining accurate resident account information

• Monitor claim status and assist with follow-up and resubmissions

• Interpret payer contracts, fee schedules, and authorization requirements

• Stay current on CMS updates and state Medicaid changes

Payment Posting & Reconciliation

• Post EFTs, checks, and resident payments accurately and timely

• Reconcile ERA/EOB documentation and identify contractual adjustments vs. underpayments

• Investigate and resolve denials, short-pays, and payment discrepancies

• Reconcile resident trust accounts and monthly statements

• Issue rate increase notices in accordance with contract terms

Collections & Account Follow-Up

• Conduct systematic follow-up on unpaid accounts

• Communicate professionally with residents, families, and responsible parties

• Coordinate with Social Security offices regarding payment issues

• Prepare collection notices and escalate accounts when necessary

• Document all collection activity within the billing system

Reporting & Financial Support

• Perform regular account reconciliations to ensure billing accuracy

• Prepare monthly AR summaries and provide variance explanations

• Support accounting, Medicaid, CMS, and financial audits

• Collaborate with accounting to resolve ledger discrepancies

Qualifications

Required

• 3–5+ years of healthcare accounts receivable experience (long-term care, senior living, or post-acute preferred)

• Experience billing Medicare and Medicaid (Southeast state experience preferred)

• Working knowledge of Managed Care billing and authorization processes

• Proficiency with healthcare billing software (Yardi, PointClickCare, MatrixCare, or similar)

• Strong understanding of UB-04 and CMS-1500 claim forms

• Proficiency in Microsoft Excel and enterprise/EHR systems

• Strong organizational, analytical, and communication skills

• Ability to work independently and manage high-volume accounts

Preferred

• Multi-state and multi-payer billing experience

• Skilled Nursing Facility (SNF) billing experience including PPS/MDS processes

• Experience in a centralized billing office model

• Knowledge of Medicaid waiver and level-of-care billing programs

• CRCP, CPB, or related certification

Skills & Competencies

• Strong attention to detail and financial accuracy

• Critical thinking and root-cause problem-solving ability

• Ability to manage competing priorities in a fast-paced environment

• Accountability and ownership of assigned AR portfolio

• Professional communication skills with residents, families, and payers

• High level of integrity and confidentiality