Medicare Billing Specialist

Job Description

Are you the right applicant for this opportunity Find out by reading through the role overview below.

Job Description

Medicare Billing Specialist

Location: Charleston, Illinois (on-site)
Reports To: Billing Director

About the Opportunity

The Medicare Billing Specialist is responsible for ensuring accurate and timely billing of all Medicare claims within a skilled nursing environment. This role requires deep knowledge of Medicare regulations and a high level of precision.

Key Responsibilities

Medicare Billing

• Prepare and submit Medicare Part A and Part B claims accurately and on time
• Ensure compliance with PDPM and all Medicare billing guidelines
• Verify documentation supports billing prior to submission

Accuracy & Compliance

• Review claims for completeness and accuracy
• Identify and resolve billing discrepancies or missing information
• Stay up to date on Medicare regulations and changes

Denials & Follow-Up

• Manage Medicare claim rejections and denials
• Correct and resubmit claims promptly
• Work closely with AR team to ensure payment is received

Systems

• Utilize PointClickCare (PCC) for billing and claim management xhyhwjd
• Maintain accurate records and documentation within systems

Qualifications

• MUST have SNF Medicare billing experience
• 3+ years of Medicare billing experience in long-term care
• Strong understanding of PDPM and Medicare regulations
• Experience with PointClickCare (PCC) required
• Detail-oriented with strong accuracy and compliance focus