Job Description

Job Description

Job Description

Medical Billing Specialist

Contract to Hire role with our client located north of Pittsburgh, PA.

Work Environment: Onsite

Overview

We are seeking an experienced Billing Specialist with a background in Skilled Nursing Care to join a dedicated healthcare finance team. In this role, you will manage the full-cycle billing process for skilled nursing and related services, ensuring timely and accurate claims submission, payment posting, and account reconciliation. The ideal candidate is detail-oriented, efficient, and experienced in Medicare billing and long-term care reimbursement methodologies.

Key Responsibilities

• Manage Medicare Part A and Part B billing for skilled nursing facilities
• Perform insurance follow-up to resolve outstanding claims and ensure timely reimbursement
• Verify insurance eligibility for skilled nursing and home health services
• Support Medicaid billing and follow-up (experience preferred)
• Utilize RUG and PDPM methodologies for accurate billing (required)
• Maintain knowledge of Consolidated Billing (preferred)
• Reconcile daily census data and prepare aging reports
• Enter and maintain diagnosis codes for skilled residents
• Record facility charges for month-end close processes
• Post private pay cash receipts , refunds, and insurance remittances
• Complete and process Other Medical Expenses (OME) forms and Representative Payee documentation
• Manage Resident Trust Accounts and process related invoices
• Update Medicare Part B and commercial insurance fee schedules annually

Qualifications

• Minimum 2+ years of Skilled Nursing Billing experience (required)
• Proficiency in Medicare Part A and Part B billing
• Knowledge of RUG, PDPM , and Consolidated Billing
• Familiarity with Medicaid , Home Health , or Hospice billing (preferred)
• Strong understanding of EOBs, remittances, and cash posting
• Excellent attention to detail, organization, and follow-up skills
• Proficient with billing software , Excel , and related healthcare systems

Skilled Nursing Billing | Medicare Part A | Medicare Part B | PDPM | RUG | Consolidated Billing | Medicaid | Home Health | Hospice | Insurance Verification | Claims Processing | EOB | Reimbursement | Healthcare Billing | Accounts Receivable | Aging Reports | Revenue Cycle | Cash Posting | Long-Term Care

About PRSG® – At Precision Recruiting Solutions Group®, we're all about you – the Accounting, Finance, and HR professionals. We specialize in understanding your career goals and values, matching you with tailored opportunities that align with your expertise. Our dedicated focus ensures you find employers who recognize and value your exceptional skills. Elevate your career in Accounting, Finance, or HR with us.

Company Description

About PRSG® – At Precision Recruiting Solutions Group®, we're all about you – the Accounting, Finance, and HR professionals. We specialize in understanding your career goals and values, matching you with tailored opportunities that align with your expertise. Our dedicated focus ensures you find employers who recognize and value your exceptional skills. Elevate your career in Accounting, Finance, or HR with us.

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