Senior Healthcare Billing Specialist

LCS company; Des Moines (IA); Hybrid; USD 60,000 - 80,000; Full time

Benefits offered by this job

Competitive pay

Great benefits

Paid vacation

Job summary

LCS is seeking a Senior Healthcare Billing Specialist to manage and mentor a billing team for skilled nursing services. The role handles claims across Medicare, Medicaid, and private insurance, ensuring timely processing and compliance with regulations.

Mentoring teammates and leading special billing projects are key responsibilities. You will work with payer relations, audits, and data input to maintain accurate AR and support Medicare Cost Reports as needed.

Qualifications

• Minimum 5 years of healthcare billing experience including Medicare, Medicaid and third-party insurance using UB04 format.
• Experience with CMS FISS/DDE systems (Noridian, Novitas, Palmetto, WPS, etc.)
• Proficient with Microsoft Word and Excel; HIPAA compliance knowledge.

Responsibilities

• Mentors and assists team members.
• Supports implementation of billing processes to improve accuracy and timeliness.
• Maintains relationships with insurance payers and resolves denials for timely payment.
• Assists with auditing and special projects as assigned.
• Compiles data for billing and generates monthly claims submissions to third-party payers.
• Ensures compliance with federal and state regulations for billing functions.
• Monitors A/R aging and highlights issues to Billing Services Manager.

Skills

Interpersonal communication

Analytical thinking

Problem solving

Teamwork

Tools

MyUnity

Point Click Care

Matrix

Waystar

Job description

The Senior Healthcare Billing Specialist is responsible for processing claims for skilled nursing services rendered to residents with third party coverage under Medicare, private insurance, Medicaid, and various co-insurance companies. This role mentors Healthcare Billing Specialists and assigned special projects.

Experience is Everything.

At LCS, experience is everything. We provide you the opportunity to use your talents in a progressive, growing organization that makes a positive difference in the lives of the seniors we serve. If you are seeking an organization that gives back, you’ll love working here. Our principles and hospitality promises define our company culture. LCS employees can be found participating in volunteer activities, getting involved in our committees or collaborating with team members in our innovative workspace. You’ll find several opportunities to grow as a professional, serve the community, and enhance the lives of seniors.

What You’ll Do:

• Mentors and assists team members.
• Assists in implementing processes and procedures at communities to help improve accuracy and timeliness of billing.
• Maintains relationships with insurance companies, and works with payers to determine reasons for denials, corrects and reprocesses claims for payment in a timely manner.
• Assists with audit preparation.
• Completes special projects as assigned.
• Compiles and inputs data for billing; generates monthly bills including electronic transmission and/or paper submission of claims to third party payers.
• Ensures compliance with current federal and state government regulations for all billing functions.
• Identifies and provides feedback about A/R billing issues to the Billing Services Manager.
• Inputs data for Skilled Nursing Facility; skilled and therapy only, submits claims to Medicare, Managed Care, Medicaid, and Commercial Insurance.
• Monitors claim processing and payments while accurately recording payments and adjustments within the billing system.
• Interfaces with Admissions staff and MDS Coordinator in review of billing information to evaluate accuracy and completeness of information for claims submission.
• Develops a culture of customer service and respect in the accounts receivable team.
• Monitors A/R aging and follows up on outstanding balances.
• Assist in preparation of Medicare Cost Reports and Credit Balance reports.
• Runs necessary reports; maintains backup and support documents.
• Attends in-service training and education sessions, as assigned.
• Performs other duties as assigned.

What We’re Looking For:

• Prefer minimum of 5 years of experience with healthcare billing, including Medicare, Medicaid and third-party insurance using the UB04 claim format.
• Experience with CMS FISS/DDE systems (Noridian, Novitas, Palmetto, WPS, etc.)
• Experience using my Unity, Point Click Care, and/or Matrix application and Waystar clearing house is a plus.
• Proficient with Microsoft Word and Excel
• Knowledge of Medicare, Managed Care and Commercial insurances.
• Extensive and current working knowledge of billing and collections of skilled nursing facility claims.
• Extensive and current working knowledge of various insurance carriers’ payment regulations including various reimbursement schemes, coinsurance and deductibles, and contractual adjustments.
• Working knowledge of HIPAA regulations and compliance.
• Ability to reduce claims in the over 90-day categories and maintain per industry standard.
• Strong interpersonal and communications skills to be able to work successfully in a team-oriented environment
• Strong analytical and problem-solving skills including the ability to understand complex reimbursement structures and the ability to apply contractual and governmental regulations to billing processes.
• Excellent oral and written communication skills.

Why Join Us?

• Industry Leader.
• Inclusive & collaborative culture.
• Top Workplace USA.
• Charity and community involvement.

Competitive pay, great benefits and vacation time. We are an equal opportunity employer with benefits including medical, dental, life insurance, disability, 401(K) with company match and paid parental leave.

Our Commitment

LCS creates living experiences that enhance the lives of seniors. You’ll see this commitment in our people. They’re talented, dedicated professionals who truly care about residents, with each conducting his or her work with integrity, honesty and transparency according to the principles of LCS. We strive to help every community succeed—strengthening available resources, establishing proven practices that lead to long-term growth and value for those living in, working for and affiliated with the community. Check us out on our website: https://www.lcsliving.com

Additional Information

Travel frequency: 0-10%

The actual title & salary will carefully consider a wide range of factors, including your skills, qualifications, experience, and other relevant factors.

A POST-OFFER BACKGROUND CHECK, INCLUDING REFERENCES IS REQUIRED.

LCS IS AN EQUAL OPPORTUNITY EMPLOYER.

Job Info

• Job Schedule Full time
• Locations 400 Locust Street, Des Moines, IA, 50309, US