Skilled Nursing Medicare Part A Billing Specialist

Cascades Verdae; Charlotte (NC); On-site; USD 55,000 - 75,000; Full time

Job summary

Cascades Verdae is seeking a Skilled Nursing Medicare Part A Billing Specialist to manage the accurate and timely billing of Medicare Part A claims. You will verify eligibility, prepare and submit claims, and work with clinical and administrative staff to maximize reimbursement while maintaining compliance.

The role requires a solid understanding of Medicare regulations, UB-04 billing, and PDPM/MDS related requirements, with experience using long-term care software such as PointClickCare,

Qualifications

• Minimum 3 years of Medicare Part A billing experience, preferably in a Skilled Nursing Facility.
• Strong knowledge of Medicare regulations, UB-04 billing, and reimbursement processes.
• Understanding of PDPM and MDS-related reimbursement requirements.

Responsibilities

• Prepare and submit Medicare Part A claims accurately and within required deadlines.
• Verify resident eligibility, insurance coverage, authorization requirements and benefits.
• Ensure billing compliance with Medicare guidelines, CMS regulations, and payer-specific requirements.
• Review MDS and PDPM data to support billing accuracy.
• Identify, research, and resolve claim rejections, denials, and payment discrepancies.
• Process admissions, discharges, payer changes, and leave of absence billing.
• Monitor Medicare accounts receivable and follow up on outstanding claims.
• Collaborate with admissions, nursing, therapy, MDS, and business office teams.
• Reconcile payments, remittances, and account balances.
• Assist with audits, appeals, and additional documentation requests.

Skills

Medicare Part A billing

Billing compliance

Healthcare documentation

Tools

PointClickCare

MatrixCare

AHT

Job description

Skilled Nursing Medicare Part A Billing Specialist

Job Category: Healthcare/General

Requisition Number: SKILL003607

• Posted : September 4, 2026
• Full-Time
• On-site

Locations

Showing 1 location

Maxwell Group | MG - Maxwell Group
3530 Toringdon Way Suite 204
Charlotte, NC 28277, USA

Description

What You'll Do

The Medicare Part A Biller is responsible for the accurate and timely billing of Medicare Part A claims, ensuring compliance with federal regulations, payer requirements, and organizational policies. This position reviews patient accounts, verifies coverage, prepares and submits claims, resolves billing issues, follows up on unpaid accounts, and works closely with clinical and administrative staff to maximize reimbursement and maintain compliance.

Key responsibilities include:

• Prepare and submit Medicare Part A claims accurately and within required deadlines
• Verify resident eligibility, insurance coverage, authorization requirements and benefits
• Ensure billing compliance with Medicare guidelines, CMS regulations, and payer-specific requirements
• Review MDS and PDPM data to support billing accuracy
• Identify, research, and resolve claim rejections, denials, and payment discrepancies
• Process admissions, discharges, payer changes, and leave of absence billing
• Monitor Medicare accounts receivable and follow up on outstanding claims
• Collaborate with admissions, nursing, therapy, MDS, and business office teams
• Reconcile payments, remittances, and account balances.
• Assist with audits, appeals, and additional documentation requests

What We're Looking For

• Minimum of 3 years of Medicare Part A billing experience, preferably in a Skilled Nursing Facility.
• Strong knowledge of Medicare regulations, UB-04 billing, and reimbursement processes.
• Understanding of PDPM and MDS-related reimbursement requirements.
• Experience with PointClickCare, MatrixCare, AHT, or other long-term care software is a plus.
• Strong attention to detail and problem-solving skills.
• Excellent communication and organizational abilities.
• Proficiency in Microsoft Office, especially Excel.
• Knowledge of Medicare Part A billing regulations
• Claims processing and accounts receivable management
• Denial resolution and appeals management
• Compliance and audit readiness
• Data analysis and reconciliation
• Time management and organization
• Customer service and communication
• Problem-solving and critical thinking

Equal Opportunity Employer
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