SNF Medicare Billing Specialist – PDPM (Skilled Nursing Facility)

Position Overview

PMTAC is seeking an experienced SNF Medicare Billing Specialist with strong knowledge of the Patient-Driven Payment Model (PDPM) and Skilled Nursing Facility (SNF) Medicare Part A billing requirements. The ideal candidate will have hands‑on experience with MDS‑driven reimbursement, HIPPS coding, and UB‑04 claim submission. This role requires a strong understanding of Centers for Medicare & Medicaid Services (CMS) billing guidelines and compliance regulations.

Key Responsibilities

• Medicare Eligibility Verification
  • Verify Medicare Part A coverage for SNF residents.
  • Confirm qualifying 3‑day hospital stay and benefit period.
  • Review secondary insurance coverage (Medicaid, Medicare Advantage, commercial payers).
• MDS & PDPM Coordination
  • Review and ensure accurate completion of Minimum Data Set (MDS) assessments.
  • Validate:
    • Clinical condit...