Top 8 Senior claims representative Jobs in Richfield, Oh

Medicaid Waiver Biller – Assisted Living
Inspirit Senior Living —Cuyahoga Falls, OH
- $76,000 - $78,000 a year
- Full-time
- Hybrid work
- 5 years
- Mid-level
- Analysis skills
- Health insurance
- Dental insurance
Quick Apply
1d
Senior Claims Representative-Auto Property Damage Hybrid
National Interstate —Richfield, OH
- $65,000 - $75,000 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Finance
- Commuter assistance
- Employee stock purchase plan
Senior Claims Representative-Auto Property Damage Hybrid
National Interstate Insurance Company —Richfield, OH
- $65,000 - $75,000 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Finance
- Commuter assistance
- Employee stock purchase plan
Quick Apply
Senior Claims Representative Bodily Injury -Hybrid
National Interstate —Richfield, OH
- $70,000 - $80,000 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Finance
- Commuter assistance
- Employee stock purchase plan
Third Party Sr. Claims Representative
Fleet Response —Hudson, OH
- $22.00 - $22.50 an hour
- Full-time
- Research
- Analysis skills
- Math
- Disability insurance
- Health insurance
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Senior Claims Representative Bodily Injury -Hybrid
National Interstate Insurance Company —Richfield, OH
- $70,000 - $80,000 a year
- Full-time
- Hybrid work
- 5 years
- Office
- Finance
- Commuter assistance
- Employee stock purchase plan
Quick Apply
8d

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Optum —Cuyahoga Falls, OH
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Medicaid Waiver Biller – Assisted Living

Inspirit Senior Living -
Cuyahoga Falls, OH

Quick Apply

Job Details

Full-time
$76,000 - $78,000 a year
1 day ago

Benefits

Health insurance
Dental insurance
Paid time off
Vision insurance
Life insurance

Qualifications

Teamwork
Long term care experience
Medicaid health insurance
Analysis skills
Continuous improvement
Electronic health record (EHR) management for billing and coding
Attention to detail
Medicaid regulations
Medicaid

Full Job Description

Welcome to Inspirit Senior Living Community!

We focus on caring for the whole person body, mind, and spirit. We provide a supportive and enriching environment for our residents, building meaningful relationships that benefit both them and our dedicated staff.

Medicaid Waiver Biller – Assisted Living (Ohio & New Jersey)

Department

Finance / Revenue Cycle Management

Reports To

Senior AR manager

Position Summary

The Medicaid Waiver Biller is responsible for accurate, timely, and compliant billing of Medicaid waiver services for assisted living communities in Ohio and New Jersey. This role ensures proper authorization, documentation, billing submission, payment posting, and follow-up in accordance with state Medicaid waiver programs and managed care requirements. The position works closely with community leadership, care teams, and state agencies to optimize reimbursement while maintaining full regulatory compliance.

Key Responsibilities

Medicaid Waiver Billing & Claims Management

Prepare, submit, and track Medicaid waiver claims for assisted living residents in Ohio and New Jersey
Ensure claims align with approved service authorizations, care plans, and level-of-care determinations
Monitor billing calendars and submission deadlines to prevent delays or denials
Resolve claim rejections, denials, and underpayments in a timely manner
Maintain accurate resident billing records in the billing system (e.g., Yardi, Eldermark, or similar)

State-Specific Program Compliance

Maintain working knowledge of:
Ohio Assisted Living Waiver (ALW)
New Jersey Managed Long Term Services and Supports (MLTSS)
Ensure billing complies with state Medicaid rules, managed care organization (MCO) requirements, and contract terms
Verify eligibility, payer enrollment, and authorizations prior to billing
Prepare and support audits, reviews, and recertifications as needed

Payment Posting & Reconciliation

Post Medicaid waiver payments and adjustments accurately
Reconcile billed revenue to payments received and identify variances
Coordinate with accounting to ensure proper revenue recognition and accruals
Assist with month-end close related to Medicaid waiver revenue

Coordination & Communication

Work closely with:
Community Executive Directors and Business Office Managers
Care teams and admissions staff
State agencies and MCO representatives
Provide guidance to operations on documentation requirements impacting billing
Respond to inquiries from state agencies and managed care plans professionally and promptly

Family Support & Medicaid Enrollment Assistance

Support residents and families through the Medicaid waiver enrollment process in Ohio and New Jersey
Provide clear guidance on application steps, timelines, and required documentation
Coordinate with admissions, business office, and care teams to ensure timely and accurate enrollment
Track enrollment status to support timely billing once eligibility is approved
Communicate clearly and compassionately with families while avoiding legal or financial advice and maintaining full regulatory compliance

Process Improvement & Reporting

Identify trends in denials, delays, or underpayments and recommend corrective actions
Assist in developing and maintaining SOPs for Medicaid waiver billing
Generate reports on billed revenue, collections, aging, and outstanding authorizations
Support census, revenue, and cash-flow forecasting related to Medicaid residents

Qualifications

Required

5+ years of Medicaid billing experience in assisted living, long-term care, or home- and community-based services (HCBS)
Direct experience with Medicaid waiver programs, preferably in Ohio and/or New Jersey
Strong understanding of:
Medicaid eligibility and authorization processes
Managed care billing and remittance advice
Documentation requirements tied to care plans and service delivery
High attention to detail and strong analytical skills
Proficiency in billing or EHR systems (Yardi preferred)
Strong written and verbal communication skills

Preferred

Experience billing:
Ohio Assisted Living Waiver (ALW)
New Jersey MLTSS
Familiarity with multi-state assisted living operations
Experience supporting Medicaid audits or state reviews
Experience with Yardi

Key Competencies

Accuracy and compliance mindset
Ability to manage high-volume, deadline-driven billing
Strong follow-up and problem-solving skills
Collaborative approach with operations and care teams
Ability to work independently in a remote or hybrid environment

Work Environment & Schedule

Remote or hybrid (depending on company policy)
Standard business hours with month-end and billing-cycle deadlines

Job Type: Full-time

Pay: $76,000.00 - $78,000.00 per year

Benefits:

Dental insurance
Health insurance
Life insurance
Paid time off
Vision insurance

Application Question(s):

Can you describe your experience with billing or electronic health record systems, specifically Yardi or similar platforms?
What experience do you have managing managed care billing, including working with remittance advice and payment reconciliation?
Would you be willing to share your experience using the Medicaid waiver in an assisted living setting?
We are looking for someone to Work remote, and in-person are you in the Akron/ Streetsboro, Ohio area?

Experience:

Medicaid billing : 5 years (Required)
Proficiency in billing or EHR systems (Yardi preferred): 3 years (Required)

Work Location: In person

Quick Apply

Refine Your Search

senior claims representative jobs in richfield, oh

Medicaid Waiver Biller – Assisted Living

Senior Claims Representative-Auto Property Damage Hybrid

Senior Claims Representative-Auto Property Damage Hybrid

Senior Claims Representative Bodily Injury -Hybrid

Third Party Sr. Claims Representative

Senior Claims Representative Bodily Injury -Hybrid

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