MDS Wound Care Biller

Job Title : MDS Wound Care Biller

Location : 2377 W Foothill Blvd, Upland, CA 91786

Company : Supportive Wound Care

About the Role :

Supportive Wound Care is seeking a highly skilled Medical Biller with a strong background in Wound Care Billing and Minimum Data Set (MDS) documentation to join our team onsite in Upland, California. This role is critical to ensuring accurate reimbursement under the Patient-Driven Payment Model (PDPM) and maintaining compliance with CMS regulations for skilled nursing facilities (SNFs).

The ideal candidate will collaborate closely with ownership, management, and clinical staff to audit invoices, submit claims, and oversee collections from Medicare, Medicaid, and commercial payers. You'll play a key role in capturing and coding wound care data, supporting MDS assessments, and helping the facility secure proper reimbursement for services rendered.

Key Responsibilities :

• Billing & Collections : Submit accurate and timely claims for wound care services; manage collections from primary, secondary, and commercial payers.
• MDS & PDPM Integration : Ensure wound care documentation aligns with MDS assessments to support proper resident classification and maximize reimbursement under PDPM.
• Auditing & Compliance : Review invoices and documentation for accuracy; verify billing submissions and payment receipts; ensure compliance with CMS and NCCI guidelines.
• Clinical Collaboration : Work with nurses, therapists, and care staff to gather complete wound documentation, including assessments and treatment rationale.
• Reporting : Generate and present billing and financial reports to ownership and management.
• Wound Coding Expertise :
• Categorize wounds (acute, chronic, open, closed)
• Document wound size, depth, bed condition, and periwound status
• Apply correct CPT & HCPCS codes for procedures like debridement, dressings, and NPWT
• Justify medical necessity and treatment plans
• Monitor IPA triggers and support interim payment adjustments

Qualifications :

Work Environment : This is a full-time, in-person role based at our Upland office. Candidates must be comfortable working onsite and collaborating with both clinical and administrative teams.

Full Benefits Package upon Hire