Catholic Elder is seeking a Billing Specialist is responsible for managing the resident financial accounts for their long-term care facility. These processes include filing insurance claims, managing payments, and accurately billing for services. The Billing Specialist plays a crucial role in revenue cycle management by verifying patient eligibility, submitting timely claims, researching and addressing denials, and resolving billing discrepancies. The Billing Specialist reports to the Controller and is a part of the Business Office.

This role offers a unique opportunity to work on a small team and be involved in a broad range of responsibilities in the business office, including interacting with residents and families.

The Billing Specialist will:

1. Process and Submit Claims – Prepare, submit, and follow up on claims with insurance companies (Medicare, Medicaid, private insurance, etc.)
2. Post and Reconcile Payments – Post payments received from insurance companies and residents, reconcile accounts and track outstanding balances.
3. Verify and Authorize Insurance – Verify patient insurance coverage and obtain necessary authorizations for services.
4. Manage Denial of Services – Investigate and resolve denied or rejected claims, including submitting appeals with supporting documentation.
5. Collect outstanding accounts and bill private carriers – Generate and send resident statements, manage payment arrangements, and follow up on outstanding balances.
6. Bill for services through the Elderly Waiver system.
7. Maintain accurate records of billing information, resident data, and financial transactions.
8. Manage entire billing process from claim submission to payment posting to ensure timely and accurate revenue collections.

REQUIRED QUALIFICATIONS:

• Associate’s degree or higher in Accounting or relevant certification.
• Minimum three years of full cycle healthcare billing experience.
• A combination of education and experience to exceed 4 years may be substituted for a degree.
• Detailed knowledge of Medicare, Medicaid and third-party reimbursement policies.
• Intermediate to Advanced skills in billing software, electronic health record (EHR) systems, Microsoft Office applications, and other relevant tools.

PREFERRED QUALIFICATIONS

• Skilled Nursing billing experience.
• MatrixCare or other EHR proficiency.

SKILLS AND ABILITIES

• Ability to manage multiple tasks/projects, prioritize effectively, and meet deadlines.
• Attention to detail with high degree of accuracy in data entry, coding, and claim preparation.
• Critical thinking skills that include ability to identify and resolve billing discrepancies, denials, and other errors.
• Demonstrated ability to effectively communicate in written, electronic, online, and in-person interactions with varied stakeholders, including, but not limited to, insurance companies, residents, families, and other staff.
• Flexibility to adjust workload based on the needs of a collaborative team.

WORK ENVIRONMENT

The noise level in the work environment is usually quiet.

The employee works in resident living areas subject to frequent interruptions.

Exposure to Infectious Diseases is mitigated by the proper use of PPE.

The employee will interact with coworkers and residents from varying socioeconomic, ethnic, cultural, and educational backgrounds.

Compensation: $54,000-$64,480 per year, non-exempt, depending on qualifications. 40 hours per week, Monday-Friday, during business hours. May require additional hours during month-end or other peak times. In-person or hybrid work possible (2 days remote, 3 days on-site, after training). Hybrid employees must reside in MN.

Benefit eligible with healthcare, dental, vision, short-term disability, and optional coverages. Employer-paid basic life and Long-Term disability.

Catholic Eldercare is an equal opportunity employer. All applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.