LOCATION:
Stratford, CT
POSITION TYPE:
Full-Time, 40-hours
SHIFT(S):
40-hours per week, days, M-F
PAY RANGE:
$70,000 - $100,000
BENEFITS - Full-Time:
• Medical, Dental, and Vision Insurance (for employee ± dependents)
• 401(k) retirement plan (with employer match or contribution)
• Employer-Paid Life Insurance
• Short- and Long-Term Disability (as applicable)
• Paid Meal Period
• Paid Time Off (PTO) - vacation, personal days, sick time
• 8 Paid Holidays
• Holiday and Overtime Pay (as per facility policy)
• Employee Assistance Program (EAP)
• Employee Discounts
• Paid Training and Orientation
• Uniform Allowance
• Longevity Awards
JOB SUMMARY:
Are you an experienced Managed Care and Skilled Nursing billing professional with a strong understanding of revenue cycle operations and reimbursement management? We are seeking a Corporate Managed Care Specialist to support our skilled nursing facilities with managed care billing, collections, authorization follow-up, and reimbursement processes across a multi-facility portfolio.
This role plays a critical part in supporting financial performance and ensuring timely reimbursement by managing payer relationships, resolving claims issues, and collaborating closely with facility and corporate teams. The ideal candidate will thrive in a fast-paced healthcare environment and demonstrate strong organizational, analytical, and follow-up skills.
RESPONSIBILITIES:
• Submit and manage Managed Care claims for Skilled Nursing Facilities (SNFs)
• Follow up on unpaid claims, denials, underpayments, and authorization issues
• Review eligibility, authorization status, and payer requirements to ensure accurate billing and reimbursement
• Work aging reports and maintain timely and accurate follow-up documentation
• Coordinate with facility Business Office Managers (BOMs), therapy departments, MDS teams, and centralized billing teams
• Identify billing trends and escalate reimbursement concerns appropriately
• Assist with payer reconciliations and revenue cycle cleanup projects
• Maintain compliance with payer guidelines, billing regulations, and company processes
• Support revenue cycle improvement initiatives and assist with resolving complex reimbursement issues
• Provide regular updates regarding claims status, collections activity, and reimbursement trends
QUALIFICATIONS:
• Minimum 2+ years of Skilled Nursing Facility (SNF) billing experience required
• Managed Care billing and collections experience strongly preferred
• Knowledge of Medicare Advantage and commercial insurance payers
• Experience with PointClickCare (PCC) required
• Experience with Inovalon preferred
• Strong understanding of SNF claims, authorizations, eligibility verification, and collections workflows
• Ability to manage multiple facilities and competing priorities simultaneously
• Strong communication, organizational, and problem-solving skills
• Proficiency with Microsoft Office (Word, Excel, Outlook) and healthcare billing systems
• Must be able to read, write, and communicate effectively in English.
PREFERRED QUALIFICATIONS:
• Experience supporting multi-facility skilled nursing or long-term care operations
• Knowledge of managed care reimbursement trends and payer regulations
• Experience with revenue cycle reporting and reconciliation processes
