Billing Specialist (Administrative)

The O aks Post Acute is a pristine 122 bed skilled nursing facility located in the heart of Orangeburg, SC. Are you looking to make a difference in the lives of those we serve? At The Oaks, we value the relationships we have in our community, with our fellow colleagues, and also with residents and family members.

We are seeking a detail-focused Business Office Specialist to handle all billing-related functions 💼. This role is exclusively responsible for financial transactions, claim processing, and resident account management, ensuring compliance with regulatory requirements ✅.

🛠️ Key Responsibilities:

• 🧮 Submit accurate billing claims for Medicare, Medicaid, private insurance, and private pay residents
• 🗂️ Maintain up-to-date resident billing records and census-related charges
• 📥 Monitor accounts receivable and follow up on outstanding balances and claim denials
• 💳 Post payments and reconcile remittances
• 📆 Assist with monthly billing cycles and generate statements for residents or responsible parties
• 🔍 Ensure billing practices comply with CMS, state, and payer-specific requirements
• 📞 Respond professionally to billing inquiries from families, payers, and auditors
• 🗃️ Prepare documentation for internal and external financial audits
• 💰 Manage resident trust funds in accordance with applicable regulations (if assigned)

📚 Qualifications:

• 🎓 High school diploma or equivalent required; Associate's degree in business or accounting preferred
• 🏥 At least 2 years of experience in healthcare billing (long-term care experience preferred)
• 🧾 Strong knowledge of Medicare, Medicaid, and commercial insurance billing
• 💻 Familiarity with billing platforms such as PointClickCare, MatrixCare, or similar
• 🔐 Working knowledge of CMS billing rules and HIPAA privacy standards
• 🎯 Excellent attention to detail and organizational skills

🌟 Preferred Skills:

• 📄 Experience handling EOBs, denial management, and resubmission processes
• 💼 Familiarity with resident trust fund oversight (per 42 CFR §483.10)
• 🧑‍💻 Proficiency in Microsoft Excel and billing software tools

🎁 What We Offer:

• 💵 Competitive pay based on experience
• 🏥 Health, dental, and vision insurance options
• 🏖️ Paid time off (PTO) and paid holidays
• 💼 Opportunities for advancement and training in a supportive team environment
• 👥 A stable, resident-centered workplace culture focused on integrity and excellence
• 🏢 Clean, professional office setting in a respected long-term care facility

Obtain managed care and Medi Cal or Medicaid authorizations including bedholds. Assist with managing resident trust fund, including printing and distributing monthly statements. Supervise business office staff, including taking appropriate disciplinary measures. Maintain census and report status changes. May attend stand up meetings at the request of the Administrator. Assist with Medi Cal or Medicaid applications. Prepare TARS as needed. Track Medi Cal and Medicaid redeterminations. Participate in billing and payment processes including preparing bank deposits. Undertake collection activity for bad debts. Completes operational requirements by scheduling and assigning employees; following up on work results. Supervisory Requirements Assist with the overall supervision and management of the business office staff. Qualification Education and/or Experience High school diploma or equivalent. Strong understanding of skilled nursing billing and payment as well as proficient in Microsoft productscomputer skills. Preferable one year experience in a long term care facility. Language Skills Ability to read technical procedures. Ability to read and comprehend policy and procedure manuals. Ability to effectively present information and respond to questions from managers and employees. Mathematical Skills Ability to apply concepts such as fractions, percentages, ratios and proportions to practical situations. Reasoning Ability Ability to solve practical problems. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Certificates, Licenses, Registrations Knowledge and experience with PCC preferred. Physical Demands The essential functions of this position require the following physical abilities: Prolong use of computer. Standing and /or walking very frequently. Sitting occasionally. Reaching with hands and arms frequently, pushing/pulling very frequently. Talking and /or hearing very frequently. Tasting and /or smelling very frequently. Lifting up to 50 pounds frequently. Climbing, balancing, stooping, kneeling, crouching or crawling occasionally. Close, distance, color, peripheral, and depth perception in vision: ability to adjust focus. Work Environment The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually low to moderate. Additional Information Note: Nothing in this job specification restricts management's right to assign or reassign duties and responsibilities to this job at any time. Critical features of this job are described under various headings above. They may be subject to change at any time due to reasonable accommodation or other reasons. The above statements are strictly intended to describe the general nature and level of the work being performed. They are not intended to be construed as a complete list of all responsibilities, duties, and skills required of employees in this position.