Private Pay Billing Specialist

The Private Pay Billing Specialist is responsible for supporting accurate and timely private pay billing, payment posting, resident account activity, collections documentation, refund processing, and accounts receivable follow-up for assigned communities. This role supports community billing resources by reviewing private pay workflows, monitoring billing and collection activity, providing training and guidance, and helping ensure resident account activity is completed in accordance with established procedures.

The position works within established billing, collections, resident trust, payment processing, and revenue cycle workflows to support accurate private pay billing, timely payment application, AR aging resolution, and consistent community billing practices.

Compensation: $33-40/hr depending on experience 

Location: this position is remote, but may require occasional travel to communities, service centers, meetings, or training sessions. Candidates must be located in a state in which HumanGood operates (CA, PA, WA, OR, ID, NV, AZ, MA).

Primary Duties & Essential Functions:

The following list includes essential functions that are fundamental to the role. The organization will engage in an interactive process to provide reasonable accommodation for qualified individuals with disabilities in accordance with applicable law.

• Support accurate and timely private pay billing activity for assigned communities, including resident statements, ancillary charges, census updates, payment processing, collections documentation, and account follow-up.
• Post private pay payments and deposits, review credit and debit balances, resolve account discrepancies, and support accurate application of resident account activity.
• Monitor community billing workflows to ensure private pay census, ancillary charges, statements, payment activity, collections notes, letters, calls, and other required documentation are completed timely and accurately.
• Review and monitor resident trust account setup, maintenance, and supporting documentation in accordance with established procedures.
• Support private pay collections processes by reviewing account activity, monitoring receivables, documenting follow-up, identifying collection issues, and escalating concerns as appropriate.
• Prepare documentation to support private pay refunds, bad debt write-offs, account corrections, and other account actions; enter approved refunds or adjustments in the applicable system.
• Lead or participate in private pay AR reviews, focused account reviews, and community billing meetings by providing account status updates, follow-up items, and billing support.
• Support Electronic Funds Transfer initiatives by assisting communities with payment enrollment campaigns, workflow follow-up, and resident account payment processes.
• Provide training, mentoring, backup support, and workflow guidance to community billers and other team members performing private pay billing or AR functions.
• Fill in for community billing team members during vacancies, leaves, or other coverage needs by performing assigned community billing duties.
• Maintain assigned metrics and communicate billing issues, workflow gaps, account concerns, and process improvement opportunities to the Revenue Cycle Manager or Director of Accounts Receivable.
• Support the development, documentation, implementation, and consistent application of private pay billing procedures, workflows, and process improvements under the direction of Revenue Cycle leadership.
• Support month-end AR and billing close activities, including report review, account balancing, charge validation, documentation, and resolution of assigned billing or account issues.
• Provide additional assistance to the revenue cycle function as needed, including support for documentation related to third-party claims and collections workflows.

Decision Authority & Scope

• Responsible for private pay billing support, payment posting, resident account follow-up, and workflow monitoring for assigned communities.
• Works independently on routine and moderately complex private pay billing, account review, payment posting, collections documentation, and workflow support within established policies, procedures, and approval guidelines.
• Reviews resident account issues, missing information, billing discrepancies, payment concerns, documentation gaps, and collection issues; resolves matters within established procedures or escalates non-routine issues to the Revenue Cycle Manager.
• Prepares recommendations and supporting documentation for refunds, adjustments, bad debt write-offs, and other account actions, but does not have final approval authority unless specifically delegated.
• Provides training, mentoring, workflow support, and backup coverage to community billing resources, but does not have direct supervisory authority, budget responsibility, or final authority for hiring, corrective action, performance evaluation, termination, or pay decisions.
• Interacts with community billing resources, residents or responsible parties as needed, revenue cycle team members, and internal stakeholders to support accurate billing, timely payment application, and account resolution.
• Maintains confidentiality of resident, billing, financial, payer, and organizational information.

Minimum Qualifications

• High school diploma or equivalent.
• Minimum of three years of accounts receivable, private pay billing, resident billing, healthcare billing, collections, payment posting, or related revenue cycle experience.
• Working knowledge of private pay billing, resident account activity, payment processing, electronic funds transfer, collections workflows, refund processing, AR aging, billing documentation, and account reconciliation.
• Experience using electronic health record, billing, accounts receivable, payment processing, spreadsheet, and Microsoft Office applications.
• Ability to review billing records, resident account activity, census information, payment documentation, aging reports, collection notes, and billing workflows for accuracy and completeness.
• Ability to research account issues, identify discrepancies, document follow-up activity, and resolve billing or collection issues within established guidelines.
• Strong attention to detail, accuracy, organization, and follow-through.
• Ability to manage deadlines, prioritize work, and maintain accurate documentation in a high-volume billing environment.
• Strong written and verbal communication skills, including the ability to explain billing, account, payment, and documentation issues clearly and professionally.
• Demonstrated customer service skills and ability to interact professionally with team members, community stakeholders, residents, and responsible parties.

Preferred Qualifications

• Associate degree or coursework in business, accounting, healthcare administration, medical billing, revenue cycle, or related field.
• Experience in senior living, skilled nursing, post-acute care, long-term care, continuing care retirement communities, or a multi-site healthcare environment.
• Experience supporting community billing workflows, resident trust processes, electronic funds transfer, private pay collections, refunds, bad debt documentation, and month-end AR close.
• Experience training, mentoring, or providing workflow support to billing, AR, or revenue cycle team members.
• Familiarity with healthcare billing systems, resident billing platforms, EHR systems, payment portals, and AR reporting tools.

Working Conditions & Physical Requirements

• Work is primarily performed in a remote, office, or administrative environment using standard office equipment.
• Requires frequent use of a computer, keyboard, mouse, telephone, video conferencing, email, spreadsheets, billing systems, EHR systems, payment systems, and other business applications.
• Requires the ability to communicate effectively by phone, video conferencing, email, and in writing.
• Requires the ability to read, review, and interpret billing records, resident account information, payment activity, account documentation, policies, procedures, and reports.
• Requires the ability to sit for extended periods and perform repetitive hand and wrist motions associated with computer and office work.
• May require occasional lifting, carrying, pushing, or pulling of office materials generally up to 20 pounds.
• May require occasional travel to communities, service centers, meetings, or training sessions.
• May require flexibility to work outside normal business hours during month-end close, coverage needs, system issues, payment deadlines, or urgent revenue cycle needs.

This job description is intended to describe the general nature and level of work performed by the position. It is not intended to be an exhaustive list of all duties, responsibilities, or qualifications. Duties may change or be assigned as business needs evolve, consistent with applicable law. The organization will provide reasonable accommodations to qualified individuals with disabilities in accordance with applicable law.
This job description is maintained by Human Resources and may be reviewed and updated periodically to reflect business needs and organizational changes.