Encore is seeking a highly experienced, detail-oriented insurance billing specialist to manage third-party billing for three skilled nursing communities in Delaware. The role is responsible for accurate and timely claim submission, insurance accounts receivable follow-up, denial resolution, payer reconciliation, and month-end billing support. The position requires independent problem-solving, close collaboration with business office and clinical teams, and the ability to maintain compliance with payer rules and organizational billing policies.
Requirements & Qualifications
- Minimum 5 years of healthcare insurance billing experience.
- At least 3 years of hands-on skilled-nursing billing experience across multiple payer types.
- Strong knowledge of Medicare Part A and Part B, Delaware Medicaid, Medicare Advantage, managed care, commercial insurance, consolidated billing, coordination of benefits, timely filing, and appeals/denials.
- Experience with PointClickCare is highly desirable; familiarity with Inovalon, Availity, Novitasphere, and Medicaid payer portals preferred.
- Proven ability to resolve complex claim, eligibility, authorization, setup, underpayment, and recoupment issues.
- High school diploma or equivalent required; associate degree or billing/coding certification preferred.
- Strong attention to detail, organization, follow-through, and analytical problem-solving skills.
- Ability to work remotely with minimal supervision and maintain availability during Eastern business hours.
- Proficiency with Microsoft Excel, Outlook, and standard office technology.
Location
Delaware, US
Employment Type
Part-time
Experience Level
Senior
Remote work allowed
Yes
Posted
1 month ago