MCR Billing Specialist

The Medicare Billing Specialist role at Tutera Senior Living & Health Care involves preparing, reviewing, and submitting Medicare Part A & B claims for skilled nursing residents, ensuring timely and accurate billing in accordance with CMS and SNF-specific guidelines. Responsibilities include verifying resident insurance eligibility, monitoring claims for proper payment, and resolving discrepancies, as well as tracking, appealing, and resolving denied or rejected claims efficiently. The specialist will collaborate with MDS coordinators to ensure billing aligns with clinical documentation under PDPM. Maintaining current knowledge of Medicare regulations, SNF billing codes, and HIPAA compliance is essential, along with communicating with Medicare MACs, community staff, and insurance providers, generating aging reports, and assist in collection efforts when required. They should support audits and provide documentation for compliance reviews.