Nursing Home Medicare Biller

Position Summary

The Nursing Home Medicare Biller is responsible for the accurate and timely billing of Medicare Part B services provided to residents in a long-term care setting. This role ensures compliance with federal regulations, payer requirements, and organizational policies while maximizing reimbursement through accurate claims submission, payment posting, and account follow-up.

Key Responsibilities

• Prepare, review, and submit Medicare Part B claims accurately and within established deadlines.
• Verify patient eligibility, insurance coverage, and benefits.
• Review documentation to ensure compliance with Medicare billing guidelines and coding requirements.
• Monitor claim status, identify billing issues, and resolve claim denials or rejections promptly.
• Post payments, reconcile accounts, and research payment discrepancies.
• Follow up on outstanding accounts receivable to ensure timely reimbursement.
• Work closely with clinical staff, rehabilitation providers, and other departments to obtain required documentation.
• Maintain current knowledge of Medicare regulations, billing procedures, and reimbursement policies.
• Ensure compliance with HIPAA, CMS regulations, and all applicable federal and state guidelines.
• Prepare billing reports and assist with audits as needed.
• Respond to inquiries from patients, insurance carriers, and internal departments regarding billing issues.
• Maintain accurate billing records and documentation.

Qualifications

• High school diploma or equivalent required; associate's degree in healthcare administration, accounting, or a related field preferred.
• Minimum of 2 years of experience in Medicare Part B billing, preferably in a skilled nursing facility or long-term care environment.
• Knowledge of Medicare Part B regulations, CPT/HCPCS coding, ICD-10 diagnosis coding, and reimbursement methodologies.
• Experience with electronic medical records (EMR) and healthcare billing software.
• Strong understanding of accounts receivable management and claims follow-up.
• Excellent analytical, organizational, and problem-solving skills.
• Strong attention to detail with the ability to manage multiple priorities.
• Proficiency in Microsoft Office, particularly Excel and Outlook.
• Effective verbal and written communication skills.

Preferred Qualifications

• Experience working in a skilled nursing facility or rehabilitation setting.
• Familiarity with Medicare Advantage plans and secondary insurance billing.
• Knowledge of payer portals and electronic claim submission systems.

Core Competencies

• Accuracy and attention to detail
• Knowledge of healthcare billing regulations
• Time management and organizational skills
• Critical thinking and problem-solving
• Customer service orientation
• Collaboration and teamwork
• Confidentiality and professionalism

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.

Here at Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers! The goal is lofty, but it is made attainable through the hard work and dedication of our teams and their willingness to lock arms together. Are you ready to lock arms with us?