Manager

• Manage the tracking and monitoring of all claims from submission to resolution for a portfolio of SNF facilities.
• Ensure that claims to Medicare, Medicaid, and private insurers are accurately submitted, tracked, and followed up on in a timely manner.
• Oversee the monitoring of accounts receivable (AR) and ensure proper tracking of unpaid claims, payment statuses, and outstanding balances.
• Implement systems and processes to track the life cycle of claims and minimize billing errors and payment delays.
• Work to proactively resolve issues before they escalate, providing clients with clear communication on their billing status.
• Track and analyze denied claims, working with billing, clinical, and administrative teams to identify root causes and implement corrective actions.
• Manage the timely resubmission of corrected claims and appeals to third-party payers, ensuring resolution of denial issues.
• Work closely with clients to address any documentation or coding errors that contribute to claim denials.
• Develop and refine workflows for tracking denials and appeals to ensure consistent follow-up and maximum reimbursement.
• Ensure compliance with third-party billing and regulatory requirements, including Medicare and Medicaid guidelines, HIPAA regulations, and other payer-specific policies.
• Track regulatory deadlines and ensure SNF clients are aware of any changes in reimbursement models, billing practices, or compliance requirements.
• Lead a team of tracking specialists and coordinators who focus on third-party billing performance for multiple SNF clients.
• Provide training and development opportunities to team members to enhance their knowledge of third-party billing, claims management, and regulatory compliance.
• Set performance goals for the team, monitor key metrics such as days in AR, claim resolution times, and denial rates.
• Foster a collaborative and results-driven team environment, ensuring high levels of performance and accountability.
• Communicate regularly with clients to ensure they are aware of their third-party billing performance and to address any concerns or issues.
• Provide reporting to clients that highlights key metrics such as claim approval rates, outstanding balances, and overall third-party payer performance.
• Develop and maintain reports and dashboards that track third-party claims performance across the portfolio of SNF clients.
• Monitor key performance indicators (KPIs) such as days in AR, collection rates, and denial trends to identify opportunities for improvement.
• Provide regular updates and recommendations to senior leadership on third-party billing performance, reimbursement trends, and areas for process improvement.
• Work with the finance and revenue cycle teams to ensure alignment of third-party billing efforts with overall financial objectives.
• Other tasks and projects as needed and assigned.

SNF Tracking Manager

Care Manager, Telephonic Nurse

Transportation Manager

Senior Manager, B2B Programs

Computer & Information Systems Manager – SME

Manager Reporting & Analytics