What are the responsibilities and job description for the Medicare/HMO Billing specialist position at Brookside Multicare Nursing Center?
Job Description
A skilled nursing and rehabilitation care services facility specializing in long-term care services, is hiring a Billing Coordinator, Medicare / HMO to streamline their billing operations and ensure accurate revenue cycle management. The Billing Coordinator, Medicare / HMO plays a vital role in managing receivable accounts, processing claims, and coordinating collections within a long-term care environment. This position offers an excellent opportunity to contribute to efficient financial operations while working closely with patients, families, and administrative staff in a dynamic setting.
Key Responsibilities
- Prepare and submit Medicare Part A and Part B claims timely and accurately.
- Bill Managed Medicare, HMO, and secondary insurance claims.
- Review census, admissions, discharges, payer changes, and authorizations daily.
- Verify eligibility, coverage, benefit periods, and payer requirements.
- Monitor UB-04 claim submissions and electronic billing transmissions.
- Follow up on rejected, denied, or unpaid claims promptly.
- Research and resolve billing discrepancies and claim edits.
- Work closely with MDS, therapy, and admissions departments to ensure accurate reimbursement.
- Review Medicare notices, demand bills, and payer correspondence.
- Maintain documentation supporting billed services and skilled coverage.
- Monitor aging reports and assist with collections for outstanding balances.
- Track authorizations and recertifications for Managed Care plans.
- Ensure compliance with Medicare regulations, CMS guidelines, and facility policies.
- Assist during audits, ADRs, RAC reviews, and insurance requests.
- Maintain accurate resident billing records within the billing system.
- Communicate with residents and families regarding Medicare coverage and patient responsibility when needed.
- Train and support backup staff for billing functions.
- Participate in month-end closing and accounts receivable reporting.
Recommended Skills
- Knowledge of Medicare Part A, Part B, PDPM, and Managed Care billing
- Understanding of SNF billing regulations and reimbursement
- Experience with electronic billing systems
- Strong organizational and follow-up skills
- Ability to analyze remittances and resolve claim issues
- Excel and reporting knowledge
- Attention to detail and deadline management
MUST HAVE MINIMUM 3 YEARS EXPERIENCE
Pay: From $41.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Vision insurance
Experience:
- Medicare/HMO : 2 years (Required)
Work Location: In person
Salary : $41