Billing Clerk for Long Term Care

Job Description

Job Description

We are a dedicated long-term care provider committed to delivering exceptional support and compassionate service to our residents. Our team works collaboratively to ensure accurate, timely, and compliant billing practices that support the financial health of our organization. We are seeking a detail-oriented Medicaid & Medicare Billing Clerk to join our business office team.

The Medicaid & Medicare Billing Clerk is responsible for managing all aspects of Medicare and Medicaid billing for our long-term care facility. This role ensures claims are submitted accurately and timely, payments are posted correctly, and denials are resolved efficiently. The ideal candidate is organized, proactive, and experienced in long-term care reimbursement.

• Prepare, review, and submit Medicare Part A, Part B, and Medicaid claims for long-term care residents

• Verify eligibility and coverage for Medicare, Medicaid, and secondary insurance payers

• Monitor claims through the entire billing cycle, ensuring timely follow-up and resolution

• Research and correct claim errors, rejections, and denials

• Post payments, adjustments, and reconcile accounts

• Maintain accurate resident billing files and documentation

• Collaborate with clinical and admissions teams to ensure accurate MDS and RUG/PDPM-related billing

• Communicate with insurance providers, state agencies, and internal departments

• Assist with month-end closing processes and reporting

• Ensure compliance with federal, state, and payer-specific regulations

• Billing for ancillary services such as labs, xrays, wounds etc.

• Previous experience in Medicaid and Medicare billing , preferably in a long-term care or SNF setting

• Strong understanding of Medicare Part A/Part B, Medicaid, PDPM, and payer guidelines

• Proficiency with billing software PointClickCare

• Excellent attention to detail and organizational skills

• Ability to manage multiple priorities and meet deadlines

• Strong communication and problem-solving abilities

• High school diploma required; additional billing or healthcare administration training preferred

• Competitive compensation

• Health, dental, and vision insurance

• Paid time off and holidays

• Opportunities for professional development

• Supportive and collaborative work environment