MCR Billing Specialist
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Job Description
MCR Billing Specialist managing Medicare billing for Tutera Senior Living & Health Care. Submitting claims and ensuring compliance with Medicare regulations in a skilled nursing environment.
Responsibilities:
- Prepare, review, and submit Medicare Part A & B claims for skilled nursing residents.
- Ensure timely and accurate billing in accordance with CMS and SNF-specific guidelines.
- Verify resident insurance eligibility, including benefits and coverage under Medicare.
- Monitor and reconcile claims for proper payment, and identify/resolve any discrepancies.
- Track, appeal, and resolve denied or rejected claims efficiently.
- Collaborate with MDS coordinators to ensure billing aligns with clinical documentation under PDPM.
- Maintain current knowledge of Medicare regulations, SNF billing codes, and HIPAA compliance.
- Communicate with Medicare MACs, community staff, and insurance providers as needed.
- Generate aging reports and assist in collection efforts when required.
- Support audits and provide documentation for compliance reviews.
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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