Medicaid & Medicare Billing Clerk

Responsible for managing Medicaid and Medicare billing for a long-term care facility. This role ensures claims are submitted accurately and on time, payments are posted correctly, and denials are resolved efficiently. The position supports the business office team and contributes to compliant, timely reimbursement.

Key responsibilities include:

• Prepare, review, and submit Medicare Part A, Part B, and Medicaid claims for long-term care residents
• Verify eligibility and coverage for Medicare, Medicaid, and secondary insurance payers
• Monitor claims through the billing cycle and ensure timely follow-up
• Research and correct claim errors, rejections, and denials
• Post payments and adjustments, and reconcile accounts
• Maintain accurate resident billing files and documentation
• Collaborate with clinical and admissions teams on MDS and RUG/PDPM-related billing
• Communicate with insurance providers, state agencies, and internal departments
• Assist with month-end closing processes and reporting
• Ensure compliance with federal, state, and payer-specific regulations
• Bill ancillary services such as labs, X-rays, and wound care