Credentialing/Billing Specialist

The Credentialing/Billing Specialist is responsible for supporting the development and implementation of the Credentialing process - credentialing new and established health care providers. The Credentialing/Billing Specialist will be expected to manage the billing cycle and a broad range of the billing processes. Billing will proactively work to maximize accurate and timely payment.

*CAQH Credentialing experience preferred*

*Not a remote position - in office only*

Essential Duties and Responsibilities

• Supporting the development and implementation of the Credentialing Processing Center policies and procedures
• Responsible for credentialing new and established health care providers, and maintenance of information to include primary source verification, follow up, data collection, data entry, and document review
• Compliance with HMA policy and procedure, Federal and State regulatory and accrediting agencies
• Process and maintain credentialing and re-credentialing in accordance with State and Federal Regulatory regulations
• Monitor collection of all information received; follow up on missing items and/or incomplete form
• Identifies and evaluates potential red flags and works in collaboration with practitioner to document the issue and physician response
• Verifying accuracy of billing data and revising any errors
• Timely resolution of all claims including appeals.
• Other duties as assigned

Other Duties as Require include the following.

• Ability to effectively communicate with providers of all specialties
• Exceptional customer service principles and practices to both internal and external customers
• Skilled in multi-tasking while managing multiple priorities
• Ability to adhere to confidentiality standards and professional boundaries at all times
• Attention to detail

Education: Associate degree or equivalent years’ experience

Full-time benefits: health, dental, vision, PTO - and much more!

Hours: 8am-5pm

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Job Type: Full-time

Pay: $50,000.00 - $52,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• Bachelor's (Required)

Experience:

• Medical billing: 2 years (Preferred)
• Medical Credentialing Specialists: 2 years (Required)

Work Location: In person