Established in 1978, Elderwood has grown to become the largest network of rehabilitation, skilled nursing, assisted living and independent living communities in Western New York, with over 60 facilities and 4,000 employees. As an Elderwood staff member, you'll have all the tools, training and resources you need to succeed. We offer a variety of positions and plenty of opportunities for growth and advancement.

Elderwood Administrative Services (Corporate Office) is seeking a full time Medical Billing Specialist to join our team.

Medical Billing Specialist (Medicare/Managed Care) Position Overview:

Elderwood Administrative Services is seeking a Medical Billing Specialist to join our growing team!
• Responsible for Managed Care and Insurance electronic claim submission and timely follow up of outstanding claims.
• Follow up on all claims over 30 days until paid in full.
• Maintain working knowledge of Managed Care and Insurance contract reimbursement and claim submission requirements.
• Knowledgeable in Medicare and supplemental co-insurance billing.
• Establish rapport with Managed Care and Insurance company service representatives.
• Monitor any denials and assist in follow up of timely appeals process.
• Conduct weekly aging reviews to address outstanding balances and document all collection efforts in PCC collection notes.

Our Competitive Compensation and Full Benefit Package includes:

• Downtown location with FREE PARKING; hybrid work environment
• Competitive wages and opportunities for advancement
• Medical, Dental, Vision Insurance
• Life insurance
• 401(k) with employer matching
• Paid Holidays
• Generous Paid Time Off

Medical Billing Specialist (Medicare/Managed Care):

• Review remittances for potential denials, rate discrepancies, and co-payments.
• Transfer co-payments and deductibles to valid payer source.
• Prepare and submit all Managed Care and Insurance claims via electronic submission.
• Submit claims for Medicare A and B, or other third party billing and rebills for reimbursement as assigned.
• Complete applicable billing adjustments relating to Managed Care and Insurance claims via electronic submission.
• Submit billing adjustments to Medicare A and B, or third party payers as assigned.
• Generate and review aging reports on a weekly-bi/weekly basis.
• Follow up on outstanding balances over 30 days. Contact Managed Care/Insurance companies for claim status and timely payment of claims.
• Prepare and submit demand bills/ /informational/discharge/no pay claims to Medicare as assigned.
• Prepare bad debt write-offs and forward to the Director of Accounts Receivable.
• Communicate information about billing and payments and answer inquiries regarding Managed Care/Insurance company charges regarding services.
• Ensure prompt responses to all requests from responsible parties, residents or third party payers regarding financial records.
• Maintain working knowledge of Managed Care and Insurance contract reimbursement and billing requirements. Assist with updates to shared location of contracts, provider manuals and updates.
• Document timely entries of collection efforts in PCC Collections module.
• Communicate and monitor any denials to facility and regional staff and assist with follow up of appeals.
• Attend Staff Meeting and required or preferred in-service training.
• Generate and develop ideas, which improve the quality of care for residents or increase job productivity and satisfaction.

Medical Billing Specialist (Medicare/Managed Care):

• High school diploma with some business training, including typing and bookkeeping required.
• Experience with electronic claim submission and follow up required.
• Experience with Microsoft Office.
• Excellent verbal and written communication skills.
• Strong organization and detail-orientation and ability to work in a fast-paced environment.
• Knowledge of the use of office machines and computer equipment.
• Ability to perform tasks to established standards of excellence.
• This position requires regular interaction with residents, coworkers, visitors, and/or supervisors. In order to ensure a safe work environment for residents, coworkers, visitors, and/or supervisors of the Company, and to permit unfettered communication between the employee and those residents, coworkers, visitors, and supervisors, this position requires that the employee be able to read, write, speak, and understand the English language at an intermediate or more advanced level.