Medicaid Biller

Vierra Communities•Falls Church, VA

6h•$75,000 - $95,000

About The Position

The Medicaid Biller is responsible for supporting our skilled nursing facilities with Medicaid billing, collections, authorization follow-up, and reimbursement processes across the assigned regions. This role serves as a SME on Medicaid and managed care programs, and state/federal compliance requirements while assisting Vierra Communities’ internal teams, responsible parties and with operational and regulatory matters. This role plays a critical part in supporting financial performance and ensuring timely reimbursement by managing payer relationships, resolving claims issues, and collaborating closely with facility and corporate teams.

Requirements

Minimum 3+ years of Skilled Nursing Facility (SNF) billing experience required
Knowledge of Medicaid and eligibility requirements a must
Experience with PointClickCare (PCC) required
Strong understanding of SNF claims, authorizations, eligibility verification, and collections workflows
Ability to manage multiple facilities and competing priorities simultaneously
Strong communication, organizational, and problem-solving skills
Proficiency with Microsoft Office (Word, Excel, Outlook) and healthcare billing systems
Must be able to read, write, and communicate effectively in English.
Meticulous Attention to Detail: Attention to detail required to accurately input data, verify insurance eligibility, and manage precise billing codes (such as ICD-10 and HCPCS) to prevent claim rejections.
Strong Analytical and Problem-Solving Skills: Ability to manage complex managed care contracts, calculate fluctuating per-diem rates, and investigate denied claims to determine the exact root cause.
Resilience and Patience: Navigating the appeals process and dealing with strict insurance representatives can be highly frustrating. A persistent, level-headed approach is necessary to follow up on unpaid balances.
Excellent Communication and Negotiation: You must clearly communicate financial responsibilities to patients and their families, while also negotiating authorization extensions or payment resolutions with case managers and insurance adjusters.
Time Management: SNF billers juggle multiple deadlines, including strict payer timely-filing limits and month-end closing cycles. Prioritization is key to keeping the revenue cycle moving.
Adaptability: The healthcare landscape—including Medicare/Medicaid guidelines and private insurance policies—frequently changes. Must be comfortable learning new software and adapting to evolving regulatory requirements.
Ethical Integrity: Requires handling sensitive patient data and financial records daily, requiring the highest level of discretion, honesty, and adherence to healthcare privacy laws

Nice To Haves

Medicare & Medicaid billing and collections experience strongly preferred
Experience with Waystar preferred

Responsibilities

Submit and manage Medicaid claims for Skilled Nursing Facilities (SNFs)
Follow up on unpaid claims, denials, underpayments, and authorization issues
Review eligibility, authorization status, and payer requirements to ensure accurate billing and reimbursement
Work aging reports and maintain timely and accurate follow-up documentation
Coordinate with facility Business Office Managers (BOMs), therapy departments, MDS teams, and centralized billing teams
Identify billing trends and escalate reimbursement concerns appropriately
Assist with payer reconciliations and revenue cycle cleanup projects
Maintain compliance with payer guidelines, billing regulations, and company processes
Support revenue cycle improvement initiatives and assist with resolving complex reimbursement issues
Provide regular updates regarding claims status, collections activity, and reimbursement trends