HMO / Managed Care Billing Specialist - Long Term Care

Job Description

Job Description

Join Our Team as an HMO / Managed Care Billing Specialist

Support Financial Accuracy in Long-Term Care

Creative Solutions in Healthcare is seeking a reliable and detail-oriented HMO / Managed Care Billing Specialist to join our growing corporate billing team! This is a full-time, in-office position (Monday–Friday), and plays a vital role in managing billing for our long-term care residents. Success in this position requires consistency, organization, excellent communication, and the ability to manage tasks in a fast-paced, deadline-driven environment.

Your Impact as an HMO / Managed Care Billing Specialist

In this role, you will :

Manage Claims Processing : Accurately process and submit HMO and managed care claims for long-term care facilities in Texas.

Resolve Account Balances : Work to reconcile patient accounts and reduce balances before they reach collections status.

Communicate Effectively : Respond to phone calls and messages promptly and courteously; address questions from patients, insurance representatives, and internal departments.

Handle Account Adjustments : Update patient demographics, initiate account adjustments, and maintain up-to-date billing records.

Support Leadership : Communicate concerns and areas for process improvement to Creative Solutions management.

Ensure Timeliness : Meet deadlines for claims submissions and account follow-ups while maintaining accuracy.

Collaborate Cross-Functionally : Coordinate with other billing team members and departments to support accurate and timely billing processes.

What Makes You a Great Fit

We’re seeking someone who :

Has 2–5 years of experience in HMO / Managed Care claims processing within a long-term care setting (Texas experience preferred).

Possesses strong computer skills, including Microsoft Excel, Microsoft Word, and the ability to learn new software programs quickly.

Demonstrates excellent communication skills—both written and verbal.

Is organized, detail-oriented, and committed to meeting deadlines.

Has a genuine interest in serving elderly and disabled individuals with professionalism and care.

Upholds the Patient Bill of Rights, Employee Responsibilities, and safety policies and procedures.

Education :

High school diploma or GED required; college degree preferred.

Why Choose Creative Solutions in Healthcare?

As one of Texas’s largest and most trusted long-term care providers, we are committed to supporting our employees with a strong foundation for professional growth and wellness.

We offer (for full-time employees) :

Comprehensive Benefits : Health, Dental, and Vision Coverage

Extra Protection : AD&D, Short-Term Disability, Cancer, Critical Illness, and more

Life Insurance : Whole and Term Policies

Professional Growth : Tuition Reimbursement for continued education

Time to Recharge : Paid Time Off

Retirement Planning : Immediate 401(k) eligibility

Unwavering Support : Exceptional corporate resources and leadership

Equal Opportunity Employer

We are committed to creating an inclusive workplace. Discrimination or harassment based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity, or any other protected characteristic is strictly prohibited.