Medical Billing Coordinator-Skilled Nursing

Bay Bluffs - Emmet County Medical Care Facility•Harbor Springs, MI

9h•Onsite

About The Position

The Medical Billing Coordinator is responsible for the accurate and timely billing, collection, reconciliation, and financial coordination of resident accounts within a long-term care and rehabilitation setting. This position manages billing processes for Medicare, Medicaid, private pay, managed care, hospice, and ancillary services while ensuring compliance with applicable federal and State of Michigan regulations. The Medical Billing Coordinator is also responsible for administration and oversight of the Resident Trust Fund Account, including deposits, withdrawals, reconciliation, and maintenance of resident financial records in accordance with CMS, Michigan Department of Licensing and Regulatory Affairs (LARA), and facility policies. This role works collaboratively with residents, families, therapy providers, nursing staff, admissions, finance, and third-party payers to support accurate reimbursement and excellent customer service.

Requirements

High school diploma or equivalent required.
Experience with Medicare, Medicaid, managed care, and private insurance billing required.

Nice To Haves

Associate degree in accounting, healthcare administration, business, or related field preferred.
Minimum of two (2) years of healthcare billing experience preferred.
Long-term care or skilled nursing facility billing experience strongly preferred.
Experience with resident trust fund management preferred.
Knowledge of long-term care reimbursement systems and payer requirements.
Understanding of Michigan Medicaid processes and regulations preferred.
Strong mathematical, reconciliation, and organizational skills.
Ability to maintain accurate financial records and documentation.
Proficient in Microsoft Office applications and healthcare billing software.
Ability to prioritize multiple tasks and meet deadlines.
Strong written and verbal communication skills.
Ability to maintain confidentiality and professionalism.

Responsibilities

Prepare, review, and submit claims for Medicare Part A and B, Michigan Medicaid, Managed care and insurance plans, Private pay residents, Hospice and ancillary service billing, Skilled rehabilitation services.
Monitor billing edits, denials, rejections, and aging reports.
Investigate and resolve unpaid claims and billing discrepancies.
Ensure timely follow-up on outstanding accounts receivable balances.
Post payments, adjustments, contractual allowances, and resident charges accurately.
Maintain accurate census and payer source information.
Coordinate benefit verification and authorization tracking as needed.
Communicate with residents and responsible parties regarding billing questions, statements, balances, and payment arrangements.
Generate monthly resident statements and maintain financial documentation.
Assist with month-end closing processes and financial reporting.
Maintain confidentiality of resident financial and health information in accordance with HIPAA requirements.
Maintain and manage resident trust fund accounts in compliance with CMS regulations, Michigan Medicaid requirements, and Facility policies and procedures.
Process resident trust deposits, withdrawals, and transfers accurately.
Complete and document daily, weekly, and monthly deposits.
Reconcile resident trust accounts and bank statements.
Maintain supporting documentation for all trust fund transactions.
Ensure resident trust balances are safeguarded and accurately recorded.
Assist residents and families with trust account questions and requests.
Prepare trust fund reports for audits and regulatory surveys.
Coordinate issuance of resident spending checks and petty cash transactions as applicable.
Maintain compliance with CMS billing requirements, Medicare and Medicaid regulations, Michigan long-term care financial regulations, and HIPAA privacy and security standards.
Support audit preparation and respond to requests for documentation.
Maintain accurate financial records for state and federal review.
Participate in facility quality assurance and compliance activities as requested.
Stay current on changes in reimbursement methodologies and billing regulations.
Collaborate with admissions, MDS, therapy, nursing, social services, and business office staff regarding payer changes and resident financial status.
Communicate effectively with insurance companies, residents, families, and external vendors.
Provide courteous and professional customer service at all times.
Assist with training or mentoring of business office support staff as assigned.

Benefits

Competitive wages
Affordable health insurance including prescription coverage, vision, and dental(Payment in lieu if already insured elsewhere)
Life Insurance
Paid Holidays
Generous PTO: accruing 120 hours in your first year of employment
Shift Differential between the hours of 7pm and 7am
Employee Assistance Plan
Employer funded retirement plan(401A) after 1st year of employment
457 retirement plan available upon hire
Education Assistance Plan(after your first year of employment)