Revenue Cycle Representative - Facilities

Revenue Cycle Representative – Facilities (SNF & LTC)

Position Summary

The Revenue Cycle Representative – Facilities (SNF & LTC) is responsible for supporting the end‑to‑end revenue cycle operations for Skilled Nursing Facility (SNF) and Long‑Term Care (LTC) services. This role performs a full range of activities including billing, cash posting, accounts receivable (A/R) follow‑up, and payer resolution. The representative ensures accurate and timely reimbursement by maintaining compliance with payer guidelines, resolving claim issues, and delivering high‑quality financial support to the organization.

Key Responsibilities

1. Billing & Claims Management

• Prepare, review, and submit electronic and paper claims for SNF and LTC services to Medicare, Medicaid, Managed Care plans, and commercial payers.

• Verify claim accuracy, including rates, patient liability, room and board charges, therapy services, and ancillary items.

• Monitor and resolve held, rejected, or denied claims prior to submission.

• Ensure billing compliance with regulatory requirements specific to SNF and LTC, including UB‑04 claim standards and state Medicaid guidelines.

• Coordinate with facility teams to reconcile documentation, correct billing issues, and ensure timely claim submission.

2. Cash Posting & Payment Reconciliation

• Post all incoming payments, adjustments, and remittance information accurately and timely into the billing system.

• Reconcile daily deposits, EFTs, ERAs, and lockbox transactions.

• Identify and correct payment discrepancies, underpayments, and payer errors.

• Process and document refunds or recoupments in accordance with internal and regulatory standards.

• Maintain accurate cash logs and ensure proper month‑end balancing.

3. Accounts Receivable (A/R) Management & Follow‑Up

• Manage an assigned A/R portfolio to reduce outstanding balances and achieve department targets.

• Conduct follow‑up with payers on unpaid, denied, or delayed claims.

• Research claim statuses using payer portals, provider lines, and remittance details.

• Initiate appeals and reconsiderations with the appropriate documentation.

• Track and resolve authorization issues, eligibility discrepancies, and coverage conflicts affecting payment.

• Collaborate with facilities to obtain clinical documentation, medical records, or supporting materials needed for claim resolution.

4. Compliance & Quality Assurance

• Maintain up‑to‑date knowledge of Medicare, Medicaid, and Managed Care SNF/LTC billing regulations.

• Follow HIPAA, regulatory, and organizational guidelines.

• Support audit initiatives by providing billing records, remittances, and payer correspondence.

• Document all actions accurately in the billing and A/R systems.

5. Cross‑Functional Collaboration

• Work closely with facility leadership, admissions, MDS teams, therapy providers, and case management to ensure billing accuracy.

• Communicate payer trends, denial patterns, and process improvement opportunities to leadership.

• Provide professional, timely responses to internal and external partners.

Qualifications

Required

• Education equivalent to a High school diploma, college degree preferred

• Experience in healthcare revenue cycle operations, billing, cash posting, or A/R.

• Knowledge of UB‑04 billing, SNF/LTC payer rules, and basic accounting principles.

• Strong computer and EMR/billing software skills.

• Excellent attention to detail and organizational skills.

Preferred

• 1–2 years of SNF or LTC billing experience.

• Familiarity with Medicare A/B, Medicaid, Managed Care, and PDPM reimbursement.

• Experience with clearinghouses and payer portals.

• Working knowledge of medical terminology and billing codes.

Core Competencies

• Accuracy & attention to detail

• Problem‑solving & analytical thinking

• Strong communication skills

• Time management and ability to prioritize

• Customer service orientation

• Team‑driven collaboration

Joining us is more than saying “yes” to making the world a healthier place. It’s discovering a career that’s challenging, supportive and inspiring. Where a culture driven by excellence helps you not only meet your goals, but also create new ones. We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates. If this sounds like the workplace for you, apply now! We commit to respond to every applicant.