Presbyterian Homes - Skokie, IL
posted about 1 month ago
Full-time - Mid Level
Skokie, IL
Nursing and Residential Care Facilities
About the position
The Med & Third Party Biller Manager at Presbyterian Homes is responsible for overseeing Medicare, Medicare Advantage, and third-party insurance billing processes. This role ensures compliance with regulations and payer guidelines while managing patient demographics, generating charges, adjudicating claims, and ensuring accurate coding. The position requires collaboration with various departments to maintain timely and accurate billing, along with adherence to corporate compliance and confidentiality policies.
Responsibilities
- Manage Medicare, Medicare Advantage, and third-party insurance billing processes.
- Review patient demographic information and update payer sequencing.
- Generate and import therapy charges related to Medicare and other insurance services.
- Adjudicate charges, adjustments, payments, and denials to resolve discrepancies.
- Work with the business office to transfer balances related to co-payments and deductibles.
- Ensure coding accuracy for Medicare and third-party payer claims.
- Participate in monthly meetings to ensure accurate billing and regulatory compliance.
Requirements
- High school diploma or GED required; advanced degree preferred.
- 3-5 years of experience in Medicare, Advantage, and third-party billing in a skilled nursing setting.
- Proficient in Microsoft Office, especially Excel, and billing applications.
- Ability to work in an electronic billing and information systems environment.
- Strong interpersonal skills and ability to handle multiple tasks to meet deadlines.
- Attention to detail and ability to work independently.
Nice-to-haves
- Experience with DDE (Direct Data Entry) for claims processing.
- Familiarity with skilled nursing billing practices.
Benefits
- 403(b) matching
- Disability insurance
- Health insurance
- Dental insurance
- Tuition reimbursement
- Paid time off
- Employee assistance program
- Vision insurance
