Long-Term Care Medical Biller

Job Description

Job Description

Long-Term Care Medical Biller

Full Time | Days

**Pay Rates Starting at $22/hr**

Garden Spot Village, located in New Holland, PA, is a Retirement Community offering innovative options for residential living, and also wellness and healthcare services.

Job Title: Long-Term Care Medical Biller

Status: Full Time

Schedule: 8am - 4pm with flexible hours

Salary Range: Starting at $22 per hour

What does Garden Spot Communities offer employees?

• Here are just an example of some of the benefits we offer:
  • Pet Insurance
  • Medical, Dental, Vision Coverage
  • First time homeowners program
  • Campus perks such as access to the new fitness center, salons, meal discounts and more!

What will I do in this role with Garden Spot?

Account Receivables and Collections:

• Monitor and manage the entire revenue cycle, ensuring timely processing and follow up with insurance carriers on unpaid or denied claims, and resolve discrepancies, disputes, or issues.
• Process payments, reconcile accounts; apply adjustments, write-offs, and refunds when necessary

Billing & Coding Compliance:

• Ensure proper coding of services using ICD-10, CPT, and HCPCS codes to maximize reimbursement and minimize denials.
• Apply appropriate modifiers, diagnoses, and procedures for all claims.
• Stay updated on changes in billing regulations, coding updates, and insurance company guidelines.
• Maintain compliance with federal and state regulations, including HIPAA.

Claim Processing & Submission:

• Review and verify patient demographic and insurance information before billing to prevent errors and claim rejections.
• Enter and post monthly ancillaries.
• Prepare, review, accurately process, and submit institutional claims (UB-04) for long-term care services, including skilled nursing, rehabilitation, and other related services in a timely fashion for Medicaid, Medicare, Advantage Plans ensuring timely filing, compliance with payer guidelines and contractual obligations.

Collaboration & Support:

• Collaborate with admissions, billing, clinical and administrative teams to ensure proper documentation and coding of services provided.
• Provide support during internal audits, assist with documentation requests, and assist in reconciling discrepancies in revenue reporting.

Customer Service:

• Respond to inquiries from residents, families, and insurance providers regarding billing and payment issues.
• Provide clear, timely, and professional communication with residents regarding their billing inquiries and balances.

Documentation & Record-Keeping:

• Maintain detailed and accurate records of all billing activities and communication with insurance providers and patients.
• Meet monthly with supervisor for A/R review

What do I need for this role with Garden Spot?

• High school diploma or equivalent required (Associate's or bachelor's preferred).
• Minimum of 2+ years of experience in medical billing, specifically within long-term care settings (skilled nursing facilities, rehabilitation centers, etc.).
• Experience in Medicaid, Medicare, and private insurance billing is preferred.
• Knowledge of UB-04 billing, ICD-10, CPT, HCPCS codes, payer guidelines for Medicare, Medicaid, and commercial insurance.
• Proficiency in medical billing software and electronic health record (EHR) systems (e.g., PointClickCare, MatrixCare, or similar).
• Understanding of Medicare and Medicaid regulations, long-term care reimbursement methods, and payer-specific billing requirements.
• Excellent analytical and organizational skills.
• Strong communication skills, both written and verbal, to work effectively with residents, insurance carriers, and healthcare teams.
• Preferred experience working in a multi-facility
• An understanding of and willingness to live out our mission and values, providing compassionate person-centered care to all residents

How is Garden Spot unique?

• Garden Spot Communities is a nonprofit organization with locations in New Holland, Akron, and Zieglerville, PA, offering healing and retirement living at its best!
• We live out our mission daily: Inspired by the life of Jesus, we cultivate vibrant community for purposeful living.
• We prioritize our values: Community, Excellence, Service, Stewardship, Innovation, and Integrity.
• We facilitate abundant opportunities for residents to live with purpose in community.
• We are committed to person-centered care: residents' needs and desires are taken into account first
• We follow a guiding principle: Be Kind. Do Good. Show Love.
• We encourage and equip our team to work hard, have fun, and make a difference!

Before completing an application, please review The Garden Spot Experience HERE to learn more about who we are, what we do and how we do it!

EOE