Medicaid Accounts Receivable Specialist

Why You Should Work With Us:

At Sinceri Senior Living, we are a fun loving, employee-centric company like no other! Maybe that’s why we have been certified by our employees as a Great Place to Work ® for our 7th Year in a row. Create your career with us and learn about all the career growth opportunities we offer.

Have we sparked your interest yet? Apply online and join our wonderful team. Questions about the application process? Come visit us and our staff will be happy to assist you!

Sinceri Senior living is proud to be an Equal Employment Opportunity employer. We celebrate diversity and do not discriminate based on race, religion, color, national origin, sex, sexual orientation, age, veteran status, disability status, or any other applicable characteristics protected by law. Minors must be at least 16 years of age to be employed by Sinceri Senior Living. Candidates submitted by unsolicited 3rd party recruiters will not be considered.

Purpose:

The Medicaid Accounts Receivable Specialist ensures accurate, timely billing and reimbursement — both general AR and Medicaid-specific — for residents across the portfolio. This role serves as the go-to expert on Medicaid processes while handling day-to-day AR duties, partnering closely with community business office staff and leadership to maintain compliance, protect revenue, and deliver excellent customer service.

Essential Job Functions:

Accounts Receivable

• Maintain daily communication with Business Office Managers (BOMs) and Executive Directors to resolve AR needs and account inquiries, providing timely, professional service (including across shared email inboxes).
• Manage the monthly billing and month-end cycle: process AR forms, verify deposits, run and validate billing, and process resident settlements.
• Review aging reports and occupancy activity to identify and resolve outstanding account issues.
• Enter payment reports, returned payments, and related adjustments; process ACH payments, resident refunds, and referral payments per company policy.
• Collaborate with community leadership and internal departments to maintain AR compliance and account accuracy.

Medicaid Billing & Reimbursement

• Support Medicaid authorization intake, verification, and documentation (electronic and community historical files); verify and enter Medicaid rates with Business Office Directors.
• Manage monthly Medicaid billing, including standardized adjustment and LOA credit methodology, and coordinate claims filing after month-end (e.g., via Sunbound), cross-checked against leaves of absence.
• Post Medicaid payments from remittance advices to the correct month of service, track overpayments as credits, and retain remittance documentation.
• Research and resolve Medicaid account discrepancies and denials, including full account audits when payments don't match billed totals; track denials, appeals, and adjustments.
• Lead scheduled Medicaid account audits (e.g., quarterly) and monitor aging of Medicaid balances over 90 days, escalating as needed.
• Verify resident Medicaid eligibility and ensure compliance with Medicaid regulations, coding guidelines, and state-specific payer requirements across all applicable states.
• Prepare reports on Medicaid reimbursement trends, denials, aging, and payment performance for leadership.
• Deliver onboarding and ongoing training to BOMs and EDs on AR and Medicaid processes, systems, and best practices.

Minimum Eligibility Requirements

• Strong knowledge of Medicaid regulations, billing, and reimbursement processes; multi-state experience a plus.
• Experience with Medicaid/healthcare billing systems and claims software; knowledge of basic accounting.
• Proficiency in MS Office (Excel, Word, Outlook).
• Strong interpersonal, oral, and written communication skills — regularly liaises with BOMs, EDs, and state agencies.
• Excellent attention to detail, analytical, and organizational skills.
• Self-directed, results-oriented, and able to work well under pressure to meet deadlines.
• Sound judgment, integrity, and a proactive, energetic approach to new challenges.