Medicare Billing Specialist

Job Description

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

• 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