Job Description: Managed Care Biller
Location:
Charleston, Illinois — On-Site (NOT A REMOTE POSITION)PLEASE READ BEFORE APPLYING: Skilled Nursing Facility Experience REQUIRED- This position REQUIRES prior billing, accounts receivable, or payer follow-up experience in Skilled Nursing Facility (SNF) or Long Term Care (LTC) environment. Candidates whose billing is limited to hospitals, physician practices, outpatient clinics, dental offices or NON- SNF facilities, WILL NOT meet the requirements for this position.
Reports To: Billing Director
About the Opportunity:
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.
Key Responsibilities:- 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-UpInvestigate 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
- SystemsUtilize PointClickCare (PCC) for billing and claim tracking
- Maintain accurate and organized billing records
Qualifications:- 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
