Position Summary
We are seeking a detail-oriented Assisted Living Billing & Collections Specialist to manage resident billing, insurance claims, Medicaid waiver billing, and private pay collections for multiple Assisted Living Facilities (ALFs). The ideal candidate has experience with Florida Medicaid waiver programs, managed care organizations, private pay billing, and accounts receivable follow-up.
Primary ResponsibilitiesResident Billing
- Prepare and submit monthly resident billing.
- Verify payer eligibility before billing.
- Maintain accurate resident billing records.
- Reconcile resident census with billing.
Medicaid / Managed Care Billing
Experience billing and following up with:
- UnitedHealthcare (UHC)
- Sunshine Health
- Florida Community Care (FCC)
- Humana (if applicable)
- Simply Healthcare
- Molina Healthcare
- Aetna Better Health
- Community Care Plan
- Any Florida Medicaid Waiver Managed Care Organization (MCO)
Responsibilities include:
- Submit initial claims.
- Correct rejected claims.
- Appeal denied claims.
- Track claim status.
- Verify authorizations.
- Coordinate with case managers.
- Ensure timely filing.
Private Pay Billing & Collections
- Generate monthly invoices.
- Apply resident payments.
- Follow up on overdue balances.
- Work with POAs and responsible parties.
- Set up payment plans when approved.
- Maintain collection notes.
Accounts Receivable
- Monitor aging reports.
- Follow up on unpaid claims.
- Resolve billing discrepancies.
- Reconcile payments received.
- Identify missing claims.
- Prepare weekly AR reports.
Resident Census Reconciliation
- Reconcile:
- Admissions
- Discharges
- Hospital holds
- Room changes
- Payer changes
- Ensure every resident is billed correctly each month.
Documentation
- Verify physician orders.
- Verify authorizations.
- Maintain billing documentation.
- Ensure compliance with Medicaid billing requirements.
Reporting
Provide weekly reports including:
- Claims submitted
- Claims pending
- Claims denied
- Claims paid
- Outstanding balances
- Private pay collections
- AR aging
- Missing documentation
Preferred Qualifications
- 2+ years of Assisted Living billing experience.
- Experience with Florida Medicaid Waiver billing.
- Experience billing:
- UHC
- Sunshine Health
- FCC
- Other Medicaid MCOs
- Knowledge of private pay collections.
- Strong AR follow-up experience.
- Excellent Excel and Google Sheets skills.
- Experience with ALIS or similar ALF software preferred.
- Strong communication and organizational skills.
Required Skills
- Insurance claim submission
- Medicaid billing
- Claim corrections
- Claim appeals
- Accounts Receivable
- Collections
- Reconciliation
- Data accuracy
- Attention to detail
- Time management
Performance Expectations
- 100% resident census reconciled monthly.
- Claims submitted within required timelines.
- Weekly AR follow-up completed.
- Reduce outstanding AR.
- Maintain billing accuracy above 98%.
- Timely follow-up on all denied or pending claims.
Compensation
- Part-Time (10–15 hours/week)
- Hourly: $15/hour, depending on experience.
- Flexible schedule.
Nice-to-Have Experience
- Florida Assisted Living (ALF)
- AHCA regulations
- Long-Term Care (LTC)
- Medicaid Waiver Programs
- Managed Care Organizations (MCOs)
- Revenue Cycle Management
- Insurance Verification
- Medical Billing
- Healthcare Collections
Pay: $15.00 per hour
Work Location: Hybrid remote in Inverness, FL 34450
