Managed Care Biller Long Term Care Skilled Nursing Only

Healthcare Nursing Center; Charleston (IL); On-site; USD 55,000 - 70,000; Full time

Job summary

Healthcare Nursing Center in Charleston, IL is seeking a Managed Care Biller to handle accurate and timely billing within a skilled nursing environment. You will manage managed care and commercial claims, verify authorizations, and ensure coding aligns with contracts.

This role requires SNF billing experience and PCC proficiency; you will work closely with the Billing Director and AR team to resolve denials and secure timely payments.

Qualifications

• 2-4+ years of managed care or commercial billing experience in healthcare.
• Must have SNF billing experience (managed care focus strongly preferred).
• Experience with PCC (PointClickCare) required.

Responsibilities

• Managed Care Billing: Prepare and submit managed care and commercial insurance claims accurately and on time.
• Authorizations & Documentation: Verify authorizations and ensure services billed align with approved coverage.
• Denials & Follow-Up: Investigate and resolve denied or rejected claims; resubmit promptly.
• Payer Communication: Communicate with managed care payers regarding claim status and payment delays.
• Systems: Use PointClickCare (PCC) for billing and claim tracking.

Skills

SNF billing

Managed care billing

Payer contracts

PCC (PointClickCare)

Attention to detail

Deadline management

Tools

PointClickCare (PCC)

Job description

Managed Care Biller

Location: Charleston, Illinois - On-Site (NOT A REMOTE POSITION)

PLEASE READ BEFORE APPLYING: Skilled Nursing Facility Experience REQUIRED- This position REQUIRES prior billing, accounts receivable, or payer follow-up experience in Skilled Nursing Facility (SNF) or Long Term Care (LTC) environment. Candidates whose billing is limited to hospitals, physician practices, outpatient clinics, dental offices or NON- SNF facilities, WILL NOT meet the requirements for this position.
Reports To: Billing Director

About the Opportunity

The Managed Care Biller is responsible for the accurate and timely billing of all managed care and commercial insurance claims within a skilled nursing environment. This role requires a strong understanding of payer contracts, authorizations, and billing nuances unique to managed care.

Key Responsibilities

Managed Care Billing

• Prepare and submit managed care and commercial insurance claims accurately and on time
• Ensure all claims meet payer-specific requirements and contract terms
• Track billing cycles and ensure deadlines are consistently met

Authorizations & Documentation

• Verify authorizations and ensure services billed align with approved coverage
• Work closely with facility teams to obtain required documentation
• Ensure accuracy of patient information, payer details, and billing codes

Denials & Follow-Up

• Investigate and resolve denied or rejected claims
• Correct and resubmit claims promptly
• Coordinate with AR team to ensure timely collections

Payer Communication

• Communicate with managed care payers regarding claim status, discrepancies, and payment delays
• Understand and apply payer contracts, rates, and billing requirements

Systems

• Utilize PointClickCare (PCC) for billing and claim tracking
• Maintain accurate and organized billing records

Qualifications

• MUST have SNF billing experience (managed care focus strongly preferred)
• 2-4+ years of managed care or commercial billing experience in healthcare
• Strong understanding of payer contracts, authorizations, and billing requirements
• Experience with PointClickCare (PCC) required
• Strong attention to detail and follow-through
• Ability to manage multiple payers and deadlines simultaneously