Medicare Billing Specialist

Healthcare Nursing Center; Charleston (IL); On-site; USD 45,000 - 65,000; Full time

Job summary

Healthcare Nursing Center in Charleston, Illinois (on-site) is seeking a Medicare Billing Specialist to manage accurate and timely submission of Medicare Part A and Part B claims. You will ensure compliance with PDPM and Medicare regulations while verifying supporting documentation.

Responsibilities include addressing denials, following up with the AR team to secure payment, and maintaining precise records in PCC and related systems. A strong attention to detail is essential.

Qualifications

• Must have SNF Medicare billing experience.
• Minimum 3+ years Medicare billing in long-term care.
• Solid understanding of PDPM and Medicare regulations.
• Experience with PCC required.
• Detail-oriented with strong accuracy and compliance.

Responsibilities

• Prepare and submit Medicare Part A and Part B claims accurately and on time.
• Verify documentation supports billing prior to submission.
• Review claims for completeness and accuracy; resolve discrepancies.
• Manage Medicare denials and follow-up; resubmit corrected claims.
• Collaborate with AR team to ensure timely payment.
• Maintain and update records in PCC and related systems.

Skills

SNF Medicare billing

PDPM regulations

Attention to detail

Tools

PointClickCare (PCC)

Job description

Medicare Billing Specialist

Location: Charleston, Illinois (on-site)
Reports To: Billing Director

About the Opportunity

The Medicare Billing Specialist is responsible for ensuring accurate and timely billing of all Medicare claims within a skilled nursing environment. This role requires deep knowledge of Medicare regulations and a high level of precision.

Key Responsibilities

Medicare Billing

• Prepare and submit Medicare Part A and Part B claims accurately and on time

• Ensure compliance with PDPM and all Medicare billing guidelines

• Verify documentation supports billing prior to submission

Accuracy & Compliance

• Review claims for completeness and accuracy

• Identify and resolve billing discrepancies or missing information

• Stay up to date on Medicare regulations and changes

Denials & Follow-Up

• Manage Medicare claim rejections and denials

• Correct and resubmit claims promptly

• Work closely with AR team to ensure payment is received

Systems

• Utilize PointClickCare (PCC) for billing and claim management

• Maintain accurate records and documentation within systems

Qualifications

• MUST have SNF Medicare billing experience

• 3+ years of Medicare billing experience in long-term care

• Strong understanding of PDPM and Medicare regulations

• Experience with PointClickCare (PCC) required

• Detail-oriented with strong accuracy and compliance focus