Medical Billing and Collections Specialist

Job Title: SNF MEDICAL BILLING & COLLECTIONS SPECIALISTLocation: NY/RemoteEmployment Type: Full-timeDepartment: Revenue Cycle / Care Management / Post‑Acute OperationsReports To: Regional Business Office ManagerJob SummaryWe are seeking an experienced and detail-driven SNF MEDICAL BILLING & COLLECTIONS SPECIALIST to manage and monitor patients requiring Skilled Nursing Facility placement with complex payer statuses. This role focuses on tracking, aging, and recovery by reviewing accounts receivables, auditing patient accounts, and payers. Tracking of Medicaid pending applications, managing private pay periods, and coordinating with SNFs, families, eligibility vendors, and internal teams to ensure continuity of care and financial accountability.This position plays a critical role in reducing and minimizing financial risk and supporting timely post‑acute placement for Medicaid and self-pay patients.Key ResponsibilitiesMedicaid Pending Tracking & CoordinationTrack all patients placed or referred to SNFs under Medicaid pending statusMonitor application progress, including submission dates, verifications, spend-downs, and county/state determinationsCoordinate with Medicaid eligibility vendors, case managers, social workers, and SNF business officesMaintain real-time Medicaid pending logs and aging reportsIdentify delays, missing documentation, or denial risks and escalate appropriatelyPrivate Pay & Collections MonitoringTrack private pay days for patients pending Medicaid approvalMonitor balances, authorized payment agreements, and exhaustion of private fundsCommunicate with families and SNF billing teams regarding payment expectations and deadlinesFlag accounts at risk for non-payment or abandonmentSupport timely conversion from private pay to Medicaid upon eligibility approvalSNF Placement & Post‑Acute CoordinationLiaise with SNF admissions and business offices regarding acceptance criteria and payer requirementsTrack admissions, authorizations, denials, discharges, and payer changesProvide daily or weekly status updates to leadership, care management, and finance teamsAssist with placement problem-solving for hard‑to‑place Medicaid and low‑resource patientsReporting & ComplianceMaintain accurate trackers, spreadsheets, and EMR documentationProduce reports on Medicaid pending census, private pay exposure, aging balances, and conversion timelinesEnsure compliance with HIPAA and state Medicaid regulationsQualificationsHigh school diploma required; Associate’s or Bachelor’s degree preferred2+ years of experience in SNF operations, Medicaid eligibility, care coordination, or post‑acute revenue cycleStrong working knowledge of SNF payer specific requirements with comprehensive understanding of insurance billing and reimbursementMedicaid pending processes and long-term care eligibilityExperience working with SNF business offices and admissions teamsProficiency in Excel/Google Sheets and EMR systems (Epic, PointClickCare, etc.)Strong follow-up, documentation, and organizational skillsPreferred ExperiencePrior SNF, Insurance billing or hospital case management experienceMedicaid eligibility vendor or financial counseling backgroundFamiliarity with state-specific Medicaid long-term care rulesSkills & CompetenciesHigh attention to detail and accuracyStrong verbal and written communication with families and facilitiesAbility to manage high-risk, time-sensitive accountsProblem-solving mindset focused on throughput and financial stewardshipSchedule & Work EnvironmentRemote trackingMay require periodic follow-up outside standard hours based on discharge needsCompensation & BenefitsCompetitive compensation based on experienceHealth, dental, and vision insurancePaid time off and holidaysOpportunity for advancement in care management or revenue operations