SNF Medicare Biller

Summary

Assembly Health is seeking a Medicare Biller to support billing operations for skilled nursing facilities. The role is responsible for billing Medicare across multiple facilities, following up on claims through payment, managing billing systems and denials, and handling Medicare-related audits, appeals, and remittances.

Responsibilities

• Bill Medicare for multiple skilled nursing facilities and ensure timely follow-up on all claims until payment is received
• Thorough understanding of Medicare guidelines, including eligibility criteria
• Experience interacting with Medicare Administrative Contractors (MACs) regarding remittances, disputes, and appeals
• Comprehensive knowledge of MCR coding and UB billing
• Familiarity with Medicare Secondary Payer (MSP) rules and skilled/non-skilled no-pay scenarios
• Knowledge of Common Working Files (CWF), credit balance reports, and the appeals process for prepayment ADRs, RAC audits, and denials
• Other duties as assigned or required by the business

Skills

• We are seeking a candidate with proven experience in SNF Medicare billing processes and strong communication and organizational skills
• The ideal candidate will be a team player, a quick learner, and proficient in writing professional emails
• Strong time management and problem-solving abilities are essential, including knowing when and how to escalate issues
• Thorough understanding of Medicare guidelines, including eligibility criteria
• Experience interacting with Medicare Administrative Contractors (MACs) regarding remittances, disputes, and appeals
• Comprehensive knowledge of MCR coding and UB billing
• Familiarity with Medicare Secondary Payer (MSP) rules and skilled/non-skilled no-pay scenarios
• Knowledge of Common Working Files (CWF), credit balance reports, and the appeals process for prepayment ADRs, RAC audits, and denials
• Strong communication and organizational skills
• Ability to write professional emails and communicate clearly with internal and external stakeholders
• Problem-solving and time management skills to handle unexpected situations
• Ability to work independently and collaboratively within a team
• DDE: Entering, correcting, and canceling regular claims, no pays, and MSPs; managing claims status and denials; audit tracking
• Inovalon: Submitting and working claims, interpreting 999/277 error and status reports, and pulling remittances using PCPrint
• Billing Software NCS and PCC: Navigating reports and billing details, submitting claims and adjustments, and managing MSP claims

Qualifications

Must Haves

• We are seeking a candidate with proven experience in SNF Medicare billing processes and strong communication and organizational skills
• The ideal candidate will be a team player, a quick learner, and proficient in writing professional emails
• Strong time management and problem-solving abilities are essential, including knowing when and how to escalate issues
• Thorough understanding of Medicare guidelines, including eligibility criteria
• Experience interacting with Medicare Administrative Contractors (MACs) regarding remittances, disputes, and appeals
• Comprehensive knowledge of MCR coding and UB billing
• Familiarity with Medicare Secondary Payer (MSP) rules and skilled/non-skilled no-pay scenarios
• Knowledge of Common Working Files (CWF), credit balance reports, and the appeals process for prepayment ADRs, RAC audits, and denials
• Strong communication and organizational skills
• Ability to write professional emails and communicate clearly with internal and external stakeholders
• Problem-solving and time management skills to handle unexpected situations
• Ability to work independently and collaboratively within a team
• DDE: Entering, correcting, and canceling regular claims, no pays, and MSPs; managing claims status and denials; audit tracking
• Inovalon: Submitting and working claims, interpreting 999/277 error and status reports, and pulling remittances using PCPrint
• Billing Software NCS and PCC: Navigating reports and billing details, submitting claims and adjustments, and managing MSP claims

Benefits

• Career growth - your next role with Assembly might not be created yet and we are waiting for your help to chart the way!
• An environment that values transparency
• Virtual and in-person events to connect with your team.
• Eligible employees may have the opportunity to participate in company bonus programs.
• Medical, dental, vision, 401(k), paid time off, and more.