Location: Charleston, Illinois (on-site)
Reports To: Billing Director
The Managed Care Biller is responsible for the accurate and timely billing of all managed care and commercial insurance claims within a skilled nursing environment. This role requires a strong understanding of payer contracts, authorizations, and billing nuances unique to managed care.
Managed Care Billing
Prepare and submit managed care and commercial insurance claims accurately and on time
Ensure all claims meet payer-specific requirements and contract terms
Track billing cycles and ensure deadlines are consistently met
Authorizations & Documentation
Verify authorizations and ensure services billed align with approved coverage
Work closely with facility teams to obtain required documentation
Ensure accuracy of patient information, payer details, and billing codes
Denials & Follow-Up
Investigate and resolve denied or rejected claims
Correct and resubmit claims promptly
Coordinate with AR team to ensure timely collections
Payer Communication
Communicate with managed care payers regarding claim status, discrepancies, and payment delays
Understand and apply payer contracts, rates, and billing requirements
Systems
MUST have SNF billing experience (managed care focus strongly preferred)
2–4+ years of managed care or commercial billing experience in healthcare
Strong understanding of payer contracts, authorizations, and billing requirements
Experience with PointClickCare (PCC) required
Strong attention to detail and follow-through
Ability to manage multiple payers and deadlines simultaneously
