***Must have Long Term Care/ Skilled Nursing Facility Medicaid Billing Experience***

Job Summary:

The Medicaid Biller is responsible for managing and processing Medicaid billing for a nursing home facility in compliance with state and federal regulations. This role plays a critical part in ensuring accurate and timely reimbursement for services rendered to residents. The Medicaid Biller works closely with the business office, healthcare providers, and government agencies to maintain efficient billing processes.

Responsibilities:

Medicaid Billing:

- Prepare and submit Medicaid claims for reimbursement in accordance with state and federal guidelines.

- Verify resident eligibility and ensure accurate documentation for Medicaid billing.

- Monitor changes in Medicaid regulations and adjust billing practices accordingly.

Documentation and Recordkeeping:

- Maintain accurate and up-to-date resident records related to Medicaid billing.

- Ensure documentation supports Medicaid billing and is in compliance with regulatory requirements.

- Collaborate with healthcare providers to obtain necessary documentation.

Claims Processing and Follow-Up:

- Monitor the status of Medicaid claims, identify and resolve any issues or denials.

- Conduct follow-up activities to ensure timely reimbursement.

- Address inquiries from government agencies and other stakeholders related to Medicaid billing.

Financial Reporting:

- Generate reports related to Medicaid billing and reimbursement for internal and external use.

- Provide regular updates to the Regional Business Office Manager on billing performance and issues.

Training and Compliance:

- Stay informed about changes in Medicaid policies, procedures, and regulations.

- Train relevant staff on proper Medicaid billing practices and compliance requirements.

- Collaborate with the Regional Business Office Manager to address compliance concerns.

Customer Service:

- Communicate with residents and their families regarding Medicaid billing inquiries.

- Provide assistance and information to internal staff on Medicaid billing matters.

Qualifications:

• High school diploma or equivalent; additional education in billing or related field is a plus.

• Previous experience in Medicaid billing in a healthcare setting, preferably in a nursing home or long-term care facility.

• Knowledge of Texas Medicaid billing regulations and procedures.

• Proficiency in Medicaid billing software and Microsoft Office Suite.

• Strong attention to detail and accuracy in data entry and documentation.

• Excellent communication and interpersonal skills.