HCBS Billing Specialist

3 days ago

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Logo of Tutera Senior Living and Health Care

Tutera Senior Living and Health Care

Healthcare Insurance • Non-profit • Wellness

Tutera Senior Living and Health Care is a company that provides high-quality senior living and healthcare services to older adults. They focus on creating a welcoming environment that promotes independence, well-being, and a high quality of life for their residents. With a team of dedicated professionals, Tutera offers various living options and healthcare solutions tailored to the individual needs of seniors.

📋 Description

• The HCBS Biller is responsible for accurately billing and submitting claims for Home and Community-Based Services (HCBS) provided to clients. • This role ensures compliance with Medicaid, Medicare, and managed care organization (MCO) requirements, and performs timely follow-up on denied or unpaid claims. • The HCBS Biller works closely with the community, case managers, county assistance staff and insurance companies to ensure maximum reimbursement for services rendered. • Prepare and submit accurate billing claims for HCBS services to Medicaid, MCOs, and other payers. • Verify client eligibility and authorizations prior to billing. • Review service documentation for completeness and compliance before submitting claims. • Track claim status and resolve denials, rejections, or payment discrepancies in a timely manner. • Post payments and adjustments to client accounts in the billing system. • Communicate with providers, case managers, and payers to resolve billing issues. • Maintain accurate and organized billing records and documentation. • Stay up-to-date with HCBS billing regulations, Medicaid rules, and payer-specific requirements. • Generate and review reports to ensure timely claim submission and follow-up. • Support audits and compliance reviews as needed.

🎯 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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