Accounts Receivable Consultant

Our organization is a mission-driven senior living provider dedicated to fostering fullness of life for older adults by providing compassionate, high-quality care. We are seeking an experienced Accounts Receivable Consultant to join our growing team. In this role, you will oversee billing operations for multiple healthcare communities such as Skilled Nursing Facilities (SNFs) and Assisted Living (AL) communities, serving as a subject matter expert who ensures timely reimbursement, regulatory compliance, and financial accuracy. This position is ideal for a self-motivated professional who thrives on analyzing complex accounts, training business office staff, and driving continuous improvement across facilities. This position requires routine travel to various locations to train staff, conduct audits, and provide hands-on support.

Pay range: $120k-$200k depending on years of experience

Key Responsibilities

Billing & Claims Management:

• Prepare, review, and process monthly billing for all payer types including Medicare Part A & B, Medicaid, Medicare Advantage, Managed Care, Hospice, MSHO products, Long-Term Care insurance, Coinsurance, and Private Pay residents.
• Accurately complete and submit claims using UB04 and HCFA 1500 forms for SNFs and ALs.
• Generate and mail private pay resident statements and process bank drafts for monthly payments.
• Verify resident eligibility, authorizations, and coverage changes in coordination with admissions and clinical teams, including verifying insurance benefits and maintaining accurate resident files.

Collections & Accounts Receivable Management:

• Maintain up-to-date accounts receivable aging reports and ensure timely follow-up on past-due accounts.
• Conduct outreach to insurance companies, residents, and responsible parties to resolve outstanding balances; make collection calls as needed.
• Monitor patient liability and NAMI (Net Available Monthly Income) requirements for Medicaid residents.
• Process and record all cash receipts for resident account balances, post payments, adjustments, and write-offs accurately in the billing system.
• Manage resident refunds, stale-dated checks, and NSF payments in a timely manner.

Compliance & Denial Management:

• Stay current on all changes in payer requirements, state/federal regulations, and share best practices across facilities.
• Process and correct insurance denials; perform root cause analysis and communicate trends to improve claims acceptance.
• Ensure all claims are submitted in compliance with federal, state, and payer-specific guidelines, including HIPAA and LTC billing regulations.
• Assist with audit requests as needed, including CPA audits, Medi-Cal audits, and Medicare bad debt audits.

Reconciliation & Reporting:

• Reconcile balance sheet accounts monthly and ensure accuracy across all payer types.
• Prepare and distribute weekly and monthly AR reports (including Top 20 AR report, aged trial balances, and consultant reports) for facility and corporate leadership.
• Identify trends in denials, delays, or payment discrepancies and escalate issues to leadership.
• Complete monthly census reconciliation and maintain accurate resident admission/discharge records.

Training & Consulting:

• Travel to various locations to train Business Office Managers and staff on standardized billing procedures and best practices.
• Provide ongoing coaching and support to facility business office personnel, setting goals and monitoring progress.
• Regularly review and audit facility processes to ensure standardized procedures are being followed; address issues and hold BOMs accountable for corrections.
• Assist with creation and implementation of standardized best practice procedures across all facilities.

Salary : $120 - $200