Billing Coordinator

Job Description

Job Description

Purpose

The Billing Coordinator manages and oversees billing activities to ensure accurate invoicing, prompt collections, adherence to the company’s policies, and compliance with federal and state regulations. The role involves collaborating closely with other department leaders, family members, and residents to resolve billing issues and keep accurate financial records.

Primary Responsibilities and Qualifications

Responsibilities:

• Prepare, review, and submit claims for Medicare Part A & B, Managed Medicare, Commercial Insurance and Private Pay 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 lead collection efforts when required.
• Support audits and provide documentation for compliance reviews.
• Post all cash received related to claims billed.
• Ability to interact with families or patient upon admission, engage with attorneys, state agencies, and work with interdisciplinary staff as required
• *Manage resident trust funds and confidential files in compliance with state and federal regulations
• Communicate with patients, responsible parties, attorneys or conservator to ensure request for information regarding Medicaid applications are responded to in a timely manner

Qualifications:

• Must have a strong working knowledge of accounts receivable in the Nursing Home setting.
• Must have at least 2 years of experience billing Medicare A & B, Managed Medicare, Commercial Insurance, and Private Pay (Including Applied Income) in a long-term care setting.
• Knowledge of Medicare billing guidelines and applicable billing codes.
• Ability to process collection letters, refer collection matters to attorney and probate court
• Experience working in PointClickCare (PCC) preferred.
• Must have a minimum of High School diploma

We are a 90-bed family-owned business, and our mission has and continues to be- Quality of Life through Quality of Care. Being part of our team at Whispering Pines is different than other "corporate" nursing home facilities. We provide ongoing training led by experienced and dedicated staff and medical professionals and in a dignified and comfortable environment. If you meet the qualifications below and are interested in learning more about Whispering Pines, we encourage you to apply.

Company Description

We are a 90-bed family-owned business, and our mission has and continues to be- Quality of Life through Quality of Care. Being part of our team at Whispering Pines is different than other "corporate" nursing home facilities. We provide ongoing training led by experienced and dedicated staff and medical professionals and in a dignified and comfortable environment. If you meet the qualifications below and are interested in learning more about Whispering Pines, we encourage you to apply.