Location: Carrollton, TX
Schedule: Full‑time role with standard business hours
Reports to: AR Manager
What We Offer You
- Competitive pay
- Performance‑based bonus opportunities
- Comprehensive health, dental, and vision insurance
- Additional supplemental benefits (life insurance, disability, accident, etc.)
- 401(k) with company match
- Generous paid time off (PTO/Sick)
- Clear career growth and advancement opportunities
- A supportive and vibrant company culture
- Many more employee perks and benefits
Job Summary
The Managed Care / Medicare Billing Specialist is responsible for managing the accounts receivable, billing, claims processing, collections, and reimbursement functions for multiple Skilled Nursing Facilities (SNFs) throughout Texas. This role focuses on optimizing the managed care and Medicare revenue cycle by ensuring accurate claims submission, timely reimbursement, denial resolution, payment posting, and regulatory compliance.
The Managed Care / Medicare Billing Specialist serves as a key contributor to revenue cycle performance by improving cash flow, reducing aging accounts receivable, minimizing claim denials, and supporting overall financial health. This position requires expertise in Medicare Part A billing, managed care billing, insurance claims processing, and long‑term care reimbursement.
Qualifications
- High school diploma required; college degree or equivalent advanced coursework preferred
- Prior managed care and Medicare billing experience in a Skilled Nursing Facility (SNF) environment required
- Strong knowledge of healthcare billing software, including American HealthTech (AHT) and/or HealthMEDX Vision preferred
- Understanding of Medicare Part A billing, managed care billing, reimbursement methodologies, and long‑term care revenue cycle operations
- Knowledge of ICD‑9 and ICD‑10 diagnosis coding principles
- Ability to prioritize workload, manage multiple deadlines, and work efficiently in a fast‑paced environment
- Strong analytical, organizational, customer service, and communication skills
- Team‑oriented mindset with willingness to support other areas of medical billing and accounts receivable
Essential Functions
- Process monthly managed care and Medicare Part A claims for multiple Skilled Nursing Facilities
- Create, submit, track, and reconcile managed care and Medicare claims
- Analyze, research, and resolve denied, rejected, or underpaid claims
- Verify Medicare eligibility, benefit periods, skilled coverage days, and payer requirements
- Post payments and ensure accurate reimbursement reporting
- Communicate with providers, facilities, payers, and internal stakeholders regarding billing questions and claim status
- Ensure all billing is accurate, complete, and compliant with federal, state, Medicare, Medicaid, and payer regulations
- Coordinate third‑party billing activities with facility personnel and operational teams
- Collaborate with fiscal intermediaries, auditors, cost report preparers, state agencies, federal agencies, and commercial insurance carriers
- Monitor accounts receivable balances and maintain aging within established company goals
- Assist with collection efforts and resolution of complex reimbursement issues
- Utilize billing software to improve workflow efficiency, claim accuracy, and revenue cycle performance
- Understand payer transmission requirements and ensure proper electronic claim submission
- Analyze and resolve technical billing issues involving claims processing, resident accounts, reimbursement calculations, and claim transmission errors
- Maintain compliance with all billing regulations, revenue cycle initiatives, and company financial management systems
- Prepare and distribute billing, reimbursement, collection, and accounts receivable reports as requested
- Support company DSO, cash collection, and reimbursement goals through proactive account management
- Perform additional duties and special projects as assigned by the AR Manager, Director of Finance, or CFO
We are an Equal Opportunity Employer. We offer an excellent benefit plan to include 401(k) with match, CEU reimbursement, vacation, sick time, holidays, medical, dental, and supplemental insurance plans, as well as a highly competitive compensation package.
Please visit cantexcc.com for more information about our organization.
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