Billing Clerk for Long Term Care

Key Responsibilities

• 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.

Qualifications

• 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