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. 

Responsibilities

The Billing Specialist will:

1. Generate and distribute accurate monthly private pay and resident resource statements for room and board, and ancillary care services in a timely manner.
2. Process payments for private pay and all other payers received via check, automatic withdrawal or EFT, and post to resident accounts in billing software.
3. 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.
4. 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.
5. Serve as the primary point of contact for resident families regarding billing inquiries, statement clarifications and other questions.
6. 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.
7. Partner with the third-party biller on matters related to insurance verification, authorizations and denials as well as insurance payment application.
8. Elderly Waiver Billing for Housing communities – work with the Executive Directors to submit claims, obtain necessary authorizations, investigate and resolve denied or rejected claims.
9. Record Keeping and Reporting – Maintain accurate records of billing information, resident data, and financial transactions.
10. Prepare routine aging reports, collections summaries and other reporting for leadership.
11. Compliance and Regulatory Adherence – Ensure compliance with all relevant billing regulations, including HIPAA and payer-specific guidelines.
12. Communication and Customer Service – Effectively communicate with insurance companies, residents and their families, and other stakeholders regarding billing inquiries and issues.

Qualifications

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.
• MatrixCare experience preferred.

SKILLS AND ABILITIES

• Ability to manage multiple tasks/projects, prioritize effectively, and meet deadlines.
• Attention to detail with high degree of accuracy in data entry, coding, and claim preparation.
• Critical thinking skills that include ability to identify and resolve billing discrepancies, denials, and other errors.
• Demonstrated ability to effectively communicate in written, electronic, online, and in-person interactions with varied stakeholders, including, but not limited to, insurance companies, residents, families, and other staff.
• Flexibility to adjust workload based on the needs of a collaborative team.

WORK ENVIRONMENT

The noise level in the work environment is usually quiet.

The employee works in resident living areas subject to frequent interruptions.

Exposure to Infectious Diseases is mitigated by the proper use of PPE.

The employee will interact with coworkers and residents from varying socioeconomic, ethnic, cultural, and educational backgrounds.

Compensation: $45,000-$65,000 per year, non-exempt, depending on qualifications. 40 hours per week, Monday-Friday, during business hours. May require additional hours during month-end or other peak times. In-person or hybrid work possible (1-2 days remote, 3-4 days on-site, after training). Hybrid employees must reside in MN.

Benefit eligible with healthcare, dental, vision, short-term disability, and optional coverages. Employer-paid basic life and Long-Term disability.

Catholic Eldercare is an equal opportunity employer. All applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.