Medicare & Medicaid Billing Specialist – Long-Term Care

Job Summary

MSI Healthcare is seeking a dedicated and detail-oriented Medicare & Medicaid Billing Specialist to manage healthcare billing and reimbursement for skilled nursing and long-term care services.

Previous hands-on experience with both Medicare and Medicaid billing is required. Candidates with skilled nursing facility, nursing home, or long-term care billing experience are strongly preferred.

The ideal candidate will have a thorough understanding of healthcare claims processing, insurance reimbursement, accounts receivable, and collections. This person will be responsible for ensuring accurate and timely claim submission, resolving billing discrepancies, following up on outstanding payments, and maintaining compliance with applicable Medicare and Oklahoma Medicaid requirements.

Responsibilities

• Prepare, review, and submit Medicare Part A, Oklahoma Medicaid, and applicable third-party insurance claims.
• Verify resident insurance coverage, payer eligibility, and billing information.
• Monitor Medicare coverage dates, skilled nursing benefit periods, covered days, and payer transitions.
• Follow up on Medicaid pending applications and eligibility issues in coordination with facility staff.
• Review billing documentation and claims for accuracy and completeness.
• Research and resolve rejected, denied, and unpaid claims.
• Submit corrected claims, adjustments, and appeals as appropriate.
• Post payments, contractual adjustments, and other account transactions accurately.
• Reconcile insurance remittance advice and investigate payment discrepancies.
• Monitor accounts receivable aging reports and follow up on outstanding balances.
• Identify underpayments, billing errors, and opportunities to improve collections.
• Maintain accurate billing records and supporting documentation.
• Communicate with facility administrators, office managers, insurance representatives, and state agencies to resolve billing issues.
• Prepare reports on billing activity, outstanding claims, accounts receivable, and collection performance.
• Stay current on Medicare, Oklahoma Medicaid, and applicable long-term care billing requirements.

Required Qualifications

• Demonstrated work experience billing both Medicare and Medicaid.
• Experience with healthcare claims submission, payment posting, and reimbursement follow-up.
• Knowledge of insurance billing procedures, claims denials, and accounts receivable management.
• Strong attention to detail and the ability to identify and resolve billing discrepancies.
• Proficiency in Microsoft Excel and healthcare billing software.
• Excellent organizational, communication, and problem-solving skills.
• Ability to work independently and manage deadlines effectively.

Preferred Qualifications

• Previous experience in a skilled nursing facility, nursing home, or long-term care setting.
• Knowledge of Medicare Part A billing and skilled nursing facility reimbursement.
• Familiarity with Oklahoma Medicaid billing and eligibility procedures.
• Experience managing Medicaid pending accounts and payer transitions.
• Knowledge of medical terminology, diagnosis coding, and electronic health records.
• Experience analyzing accounts receivable aging reports and improving collections.

About MSI Healthcare

MSI Healthcare supports the operations of skilled nursing and long-term care facilities in Oklahoma. We value dependable, detail-oriented professionals who take ownership of their responsibilities and contribute to accurate billing, timely reimbursement, and strong financial performance.

Pay: $22.00 - $28.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $22 - $28