Medicare Billing Specialist

Key Responsibilities

• Prepare, review, and submit Medicare Part A & B claims for 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 assist in collection efforts when required.
• Support audits and provide documentation for compliance reviews.

Qualifications

• A fire and passion for working with seniors
• A flexible, fun, and energetic personality
• Prior experience with managing complex billing scenarios
• Extensive knowledge of billing procedures for all payer types, including Medicare, Medicaid, private insurance, and others
• Proficiency with billing software and electronic medical record (EMR) systems
• Ability to work well with others in a team environment
• Proficiency in Microsoft Word, Excel, and Outlook
• Excellent written and oral communication skills

Benefits

• Advanced Pay Financial Literacy Classes
• Employee Assistance Program offering Mental Health Resources, Legal Guidance, Financial Information, and more!
• Child Care Discount
• Health Insurance
• Dental Insurance
• Vision Insurance
• Life Insurance
• 401(k) for Eligible Locations
• Tuition Reimbursement
• Paid Time Off
• Holiday Pay
• Exclusive Tutera Perks
• Tutera University Advancement Opportunities