Medicare Billing Specialist

Job Title MCR Billing Specialist – Tutera Senior Living & Health Care Job Summary We are seeking an experienced and detail‑oriented Medicare Billing Specialist with expertise in Skilled Nursing Facility (SNF) billing. The ideal candidate will be responsible for the accurate and timely submission of Medicare claims, ensuring compliance with all CMS regulations, and following up on payments and denials. This role plays a critical part in the financial health of our facility and requires deep knowledge of Medicare Part A and B, PDPM, and MDS integration. Key Responsibilities Prepare, review, and submit Medicare Part A & B claims for skilled nursing residents. Ensure timely and accurate billing in accordance with CMS and SNF‑specific guidelines. Verify resident insurance eligibility, including benefits and coverage under Medicare. Monitor and reconcile claims for proper payment, and identify/resolve any discrepancies. Track, appeal, and resolve denied or rejected claims efficiently. Collaborate with MDS coordinators to ensure billing aligns with clinical documentation under PDPM. Maintain current knowledge of Medicare regulations, SNF billing codes, and HIPAA compliance. Communicate with Medicare MACs, community staff, and insurance providers as needed. Generate aging reports and assist in collection efforts when required. Support audits and provide documentation for compliance reviews. Qualifications Fire and passion for working with seniors. Flexible, fun, and energetic personality. Detailed knowledge of Illinois Medicaid regulations. Prior experience managing complex billing scenarios. High school diploma or equivalent required. Associate or bachelor’s degree in a related field preferred. Minimum of 3‑5 years of billing experience in a LTC/SNF setting. Extensive knowledge of billing procedures for all payer types, including Medicare, Medicaid, private insurance, and others. Proficiency with billing software and electronic medical record (EMR) systems. Ability to work well in a team environment. Proficiency in Microsoft Word, Excel, and Outlook. Professional image in appearance and behavior. Excellent written and oral communication skills. Benefits Advanced Pay Financial Literacy Classes Employee Assistance Program offering mental health resources, legal guidance, financial information, and more. Child Care Discount Health Insurance Dental Insurance Vision Insurance Life Insurance 401(k) for eligible locations Tuition Reimbursement Paid Time Off Holiday Pay Exclusive Tutera Perks Tutera University Advancement Opportunities Tutera offers stability; our family‑owned company was founded in 1985. Tutera offers a competitive starting wage. Tutera is dedicated to growing and developing employees through Tutera University. Equal Opportunity Employer. The wage and benefit information provided in this listing is subject to change. Benefits eligibility criteria must be met to enroll in available benefits. Job ID 2026-18798 #J-18808-Ljbffr