Abrar Admin

PMTAC Private Limited

<div>
 
 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 &amp; Medicaid Services (CMS) billing guidelines and compliance regulations.
 
 
 
 Key Responsibilities
 
 
 
 <ul>
 <li>
 Medicare Eligibility Verification
 </li>
 <li>
 Verify Medicare Part A coverage for SNF residents.
 </li>
 <li>
 Confirm qualifying 3-day hospital stay and benefit period.
 </li>
 <li>
 Review secondary insurance coverage (Medicaid, Medicare Advantage, commercial payers).
 </li>
 <li>
 MDS &amp; PDPM Coordination
 </li>
 <li>
 Review and ensure accurate completion of Minimum Data Set (MDS) assessments.
 </li>
 <li>
 Validate:
 </li>
 <ul>
 <li>
 Clinical conditions
 </li>
 <li>
 Functional status
 </li>
 <li>
 Comorbidities
 </li>
 </ul>
 <li>
 Confirm HIPPS code generation from MDS.
 </li>
 <li>
 Ensure documentation supports PDPM classification.
 </li>
 <li>
 Understand and apply the guidelines of the Patient-Driven Payment Model.
 </li>
 <li>
 UB-04 (CMS-1450) Claim Preparation
 </li>
 <li>
 Prepare and submit facility claims using the UB-04 (CMS-1450) form.
 </li>
 <li>
 Accurately complete required fields including:
 </li>
 <ul>
 <li>
 Type of Bill (21X)
 </li>
 <li>
 Statement Covers Period
 </li>
 <li>
 Revenue Codes (0022&ndash;0029 for PDPM)
 </li>
 <li>
 HIPPS Code
 </li>
 <li>
 Units (covered days)
 </li>
 <li>
 Total Charges
 </li>
 <li>
 Occurrence Codes (qualifying hospital stay)
 </li>
 </ul>
 <li>
 Ensure proper reporting of PDPM per diem billing structure.
 </li>
 <li>
 Claim Submission &amp; Follow-Up
 </li>
 <li>
 Submit claims electronically via EDI/clearinghouse or CMS DDE.
 </li>
 <li>
 Work with Medicare Administrative Contractors (MACs).
 </li>
 <li>
 Monitor claim status and resolve denials or RTPs.
 </li>
 <li>
 Submit corrected claims when MDS or HIPPS codes change.
 </li>
 <li>
 Payment Reconciliation &amp; Post-Processing
 </li>
 <li>
 Post Medicare payments and reconcile PDPM variable per diem rates.
 </li>
 <li>
 Identify underpayments or discrepancies.
 </li>
 <li>
 Coordinate professional claims (CMS-1500) separately from facility billing.
 </li>
 <li>
 Compliance &amp; Audit Readiness
 </li>
 <li>
 Ensure clinical documentation supports billed services.
 </li>
 <li>
 Maintain compliance with CMS and Medicare billing regulations.
 </li>
 <li>
 Assist with audits and ADR responses.
 
 </li>
 </ul>
 
 Required Qualifications
 
 
 
 <ul>
 <li>
 Minimum 2&ndash;3 years of SNF Medicare Part A billing experience.
 </li>
 <li>
 Strong knowledge of PDPM reimbursement methodology.
 </li>
 <li>
 Experience working with MDS assessments and HIPPS coding.
 </li>
 <li>
 Proficiency in UB-04 (CMS-1450) claim preparation.
 </li>
 <li>
 Understanding of revenue codes 0022&ndash;0029.
 </li>
 <li>
 Familiarity with Medicare Administrative Contractors (MACs).
 </li>
 <li>
 Experience with electronic billing systems and clearinghouses.
 </li>
 <li>
 Strong attention to detail and regulatory compliance knowledge.
 
 
 </li>
 </ul>
 
 Preferred Qualifications
 
 
 
 <ul>
 <li>
 RHIT, RHIA, CPC, or CPB certification.
 </li>
 <li>
 Experience in long-term care or post-acute care settings.
 </li>
 <li>
 Knowledge of Medicare Advantage SNF billing.
 
 
 </li>
 </ul>
 
 Core Competencies
 
 
 
 <ul>
 <li>
 Knowledge of PDPM case-mix components (PT, OT, SLP, Nursing, NTA).
 </li>
 <li>
 Understanding of variable per diem adjustments.
 </li>
 <li>
 Ability to analyze MDS-driven reimbursement.
 </li>
 <li>
 Strong denial management skills.
 </li>
 <li>
 Excellent documentation review and audit readiness skills.
 
 
 </li>
 </ul>
 Interested candidates with
 
 SNF Medicare Billing Specialist
 
 are encouraged to apply by sharing their CV at:
 
 
 
 careers@pmtac.com
 
 
 
 <ul>
 <li>
 arslan@pmtac.com Subject: SNF Medicare Billing Specialist
 </li>
 </ul>
</div>

SNF Medicare Billing Specialist – PDPM (Skilled Nursing Facility)

<div>
 We are seeking experienced Billing Executives with expertise in GI procedures, Anesthesia, and Pathology. The ideal candidate will have a strong focus on billing, modifier usage, reading reports to calculate accurate anesthesia units, Payment Posting, claim follow-up, denial management, and efficient resolution of denied claims while staying informed about new payers and policies. The candidate must also have experience with AdvantX Practice Management Solutions and Waystar Clearing House.
 
 
 
 Key Responsibilities
 
 
 
 <ul>
 <li>
 Must have sound knowledge of billable CPT and ICD codes for GI procedures, Anesthesia, and Pathology.
 </li>
 <li>
 Should be familiar with LCD and NCD policies for payers to ensure billing compliance with insurance guidelines.
 </li>
 <li>
 Must understand reading reports to calculate accurate anesthesia units, modifier usage for GI procedures, Anesthesia, and Pathology CPT codes.
 </li>
 <li>
 Ensure accurate processing of claims, including eligibility verification and benefit coordination.
 </li>
 <li>
 Communicate with insurance providers and patients to resolve claim-related issues.
 
 
 </li>
 </ul>
 
 Stay updated on new payers, policies, and industry changes affecting claims.
 
 
 
 
 Qualifications
 
 
 
 <ul>
 <li>
 Minimum graduation
 </li>
 <li>
 Experience in GI procedures, Anesthesia, and Pathology billing, Payment Posting, Follow-up
 </li>
 <li>
 He must also have experience with AdvantX Practice Management solutions, and WayStar Clearing House.
 </li>
 <li>
 Strong knowledge of insurance processes, billing guidelines, and new payer policies.
 </li>
 <li>
 Excellent communication, problem-solving, and organizational skills.
 </li>
 <li>
 Proficiency in Excel.
 
 
 </li>
 </ul>
 
 Why Join Us
 
 
 
 <ul>
 <li>
 Work in a professional and supportive environment.
 </li>
 <li>
 Opportunity for career growth and development.
 </li>
 <li>
 Competitive salary and monthly bonuses.
 </li>
 <li>
 Comprehensive training to ensure your success in the role.
 </li>
 <li>
 Medical Insurance for self, spouse, and children.
 </li>
 <li>
 Increments on successful completion of probation period.
 </li>
 <li>
 Bi-annual increments
 </li>
 <li>
 Travel allowance (For Female Employees)
 
 
 </li>
 </ul>
 
 Job Time:
 
 6:00 pm - 3:00 am (On-site)
 
 
 
 Job Location:
 
 Rawalpindi, Pakistan
 
 
 If you are passionate about making a difference, possess exceptional communication skills, and are ready to take on new challenges, we encourage you to apply.
 
 
 
 How To Apply
 
 
 
 <ul>
 <li>
 Please send your updated resume and a brief cover letter outlining your suitability for the position to careers@pmtac.com
 </li>
 <li>
 We also accept Walk-In Interviews: Monday to Friday | 6:00 pm - 10:00 pm PKT
 
 
 </li>
 </ul>
 
 Office Address:
 
 
 Office# 7, 1st floor, Software Technology Park, Meridian Mall, NADRA Service Centre Rehmanabad Murree Road Rawalpindi.
 
</div>

Billing Executive / Senior Billing Executive

<div>
 
 Department:
 
 Finance
 
 
 
 Responsibilities:
 
 Bookkeeping and Financial Reporting
 
 
 
 Requirements:
 
 Bachelors
 
 
 
 Skills
 
 
 
 <ul>
 <li>
 Knowledge of QuickBooks is preferred
 </li>
 <li>
 Proficiency in bookkeeping and financial reporting
 
 
 </li>
 </ul>
 
 Experience
 
 
 
 <ul>
 <li>
 Relevant experience in accounting and reporting will be an advantage
 
 
 </li>
 </ul>
 
 What We Offer
 
 
 
 <ul>
 <li>
 Market competitive salary
 </li>
 <li>
 Probation increments
 </li>
 <li>
 Monthly performance-based bonus
 </li>
 <li>
 Monthly HR bonus
 </li>
 <li>
 Biannual increments
 </li>
 <li>
 Medical coverage
 </li>
 <li>
 Opportunities for personal growth and career advancement
 </li>
 </ul>
</div>

Accountant

Join PMTAC Private Limited and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

PMTAC Private Limited

About Company

SNF Medicare Billing Specialist – PDPM (Skilled Nursing Facility)

Billing Executive / Senior Billing Executive

Accountant