HCBS Billing Specialist
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Job Description
HCBS Biller at Tutera Senior Living responsible for billing claims compliance. Collaborate with case managers and insurance companies for maximum reimbursement.
Responsibilities:
- The HCBS Biller is responsible for accurately billing and submitting claims for Home and Community-Based Services (HCBS) provided to clients.
- This role ensures compliance with Medicaid, Medicare, and managed care organization (MCO) requirements, and performs timely follow-up on denied or unpaid claims.
- The HCBS Biller works closely with the community, case managers, county assistance staff and insurance companies to ensure maximum reimbursement for services rendered.
- Prepare and submit accurate billing claims for HCBS services to Medicaid, MCOs, and other payers.
- Verify client eligibility and authorizations prior to billing.
- Review service documentation for completeness and compliance before submitting claims.
- Track claim status and resolve denials, rejections, or payment discrepancies in a timely manner.
- Post payments and adjustments to client accounts in the billing system.
- Communicate with providers, case managers, and payers to resolve billing issues.
- Maintain accurate and organized billing records and documentation.
- Stay up-to-date with HCBS billing regulations, Medicaid rules, and payer-specific requirements.
- Generate and review reports to ensure timely claim submission and follow-up.
- Support audits and compliance reviews as needed
Requirements:
- A fire and passion for working with seniors
- A flexible, fun, and energetic personality
- Must possess detailed knowledge of Illinois Medicaid regulations
- Must have prior experience with managing complex billing scenarios
- High school diploma, or equivalent, required
- Associate or bachelor’s degree in a related field preferred
- Must have a minimum of 3-5 years of prior experience in billing in a LTC/SNF setting
- Extensive knowledge of billing procedures for all payer types, including Medicare, Medicaid, private insurance, and others required
- Proficiency with billing software and electronic medical record (EMR) systems required
- Must be able to work well with others in a team environment
- Proficiency in Microsoft Word, Excel, and Outlook required
- Professional image in both appearance and behavior
- Excellent written and oral communication skills.
Benefits:
- Health Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Accident Insurance
- Critical Illness Insurance
- Cancer Insurance
- Short Term and Long Term Disability
- 401(k) with Matching Contributions
- Tuition Reimbursement
- Paid Time Off
- Holiday Pay
- Birthday Day Off
- Exclusive Tutera Perks
- Advancement Opportunities & More!
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