Billing And Credentialing Specialist Jobs

Investigate candidates’ prior education, experience, and training to see if they qualify for a certain certificate.

A minimum of 2 years of Hospital credentialing experience.

Knowledge of medical credentialing procedures.

Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS).

Excellent communication and organizational skills. Proficient in MS Word and Excel.

Examine resumes, transcripts, and letters of recommendation to ascertain a candidate’s suitability for a position.

Strong leadership and management experience. Desire to advance career in management.

3+ years’ experience in management role; medical office management experience preferred including billing experience

Solid computer skills—requirement of proficiency in MS applications—Word, Excel, Outlook, EHR system (Valant)

Review of office charges and patient information is verified, including pre-certification and referrals are obtained

Be an active participant in Program Manager meetings (when requested), staff meetings, and QACC

Must possess excellent writing and communication skills.

EMR Experience Preferred - Athenahealth Practice Management System

Accounts Receivable Collections & Management

Ability to effectively present information and respond to questions from groups of managers, patients, and the general public

Maintain and follow strict privacy, confidentiality, and safety protocols. Comply with all government regulations around the following:

Ability to define problems, collect data, establish facts, and draw valid conclusions

Health insurance plan options for you and your dependents

Work environment: PAIC; Position is fully remote

1 year experience in a Healthcare Field, Customer Service, Telemarketing, or Call Center environment (REQUIRED)

Working knowledge of Medical Terminology (REQUIRED)

Requires good written, oral, and telephone communication skills.

Requires knowledge of general office equipment, PCs, and associated software packages.

General knowledge of medical terminology preferred.

Enjoy eligible holidays at home while getting paid with our Paid Holiday plan

Collects and resolves denials of claims posted for ABA services under the direction of ABA Billing Manager.

Communicates to the ABA Billing Manager regarding any claims denied, deemed uncollectible, and outstanding receivables.

Acts as a good steward of Damar and/or client finances.

Minimum of 3 years accounting or finance experince will be accepted in lieu of a degree

Minimum age of 21 depending on program and / or department requirements.

Remote or hybrid work, FT with benefits, 40K+

Experience with multiple insurances, experience with CBH, Credible, Excel

Must be detail oriented, motivated, reliable, a team player.

-Identify and document each commercial payer's policy and procedures regarding coverage, priorauthorizations,andsubmissionprocess

-Follow up with commercial insurance payers to check status of previously submitted priorauthorization

-Quick to respond and communicate any changes in client's prior authorization status to careoperations,clinical,andpartnershipsteams.

Must have knowledge and experience in Spreadsheet (MS Excel, Numbers) and Word processing (MS Word or Pages) software

Has previous experience in customer service and strong communication skills

Must have at least 3 years of extensive Construction related Contract Administration experience, including adherence to all contracting principles and procedures

Prior experience in billing and invoice creation is required

Prior experience with government contracts, especially FAR-compliant cost-plus-fixed fee invoicing, is strongly preferred

Must have analytical and problem-solving skills

Responsible for communicating provider changes to contracted health plans and Altais Medical Group management via standardized report(s)

Works with payors to facilitate issue resolution, re-enrollment, and termination requirements

Facilitate annual employee health requirements for providers

Excellent computer skills including Microsoft Office (Word, Outlook, Excel, PowerPoint)

Excellent communication skills, both written and verbal

3+ years of Health Plan/Medical Group experience with preferred experience with an IPA

Assist COO with contract management and budget tracking.

Manage company accounting records including accounts receivables, receipts, and customer information.

3+ years of hands-on, work-related billing, invoicing, or accounting experience.

Excellent organizational skills with high attention to detail.

Strong communication skills and ability to effectively collaborate in a team environment.

Experience in government contracting in the A/E industry highly preferred.

Strong organizational and time management skills

2+ years of experience in billing and collections

Previous software industry experience (preferred)

Excellent written and verbal communication skills

Prepare and book journal entries

Assist with the month-end close

Credit and collections experience preferred

Excellent full time benefits including comprehensive medical coverage, dental, and vision options

Applies GMP/GLP in all areas of responsibility, as appropriate

Demonstrates and promotes the company vision

Release all pharmaceutical and environmental invoices on a daily basis

Research and respond to client requests (internal/external)

Strong time management skills with the ability to determine priorities and critical tasks.

Serve as a liaison with subscribers, groups, and agencies to answer eligibility, benefit, payment, electronic enrollment file and contract questions.

Experience in bookkeeping, AP/AR, accounting, or a related field.

Detail-oriented with the ability to understand benefits and contract provisions.

Strong written and verbal communication skills.

Skill/ability related to comprehension, organization, reasoning/decision-making and communication appropriate to position/level

Prepare Utilization Management and statistical reports related to all programs for Samaritan PSO meetings

Verify client insurance coverage and benefits

Submit insurance billing information to managed care organizations, monitor payments and denials of payment

Conduct Level 1 audits in accordance with applicable agecy policy and procedure

Maintain Staff Training Log and TnCare required training for staff on Relias. Maintain training documentation on all staff members

Participate in Professional Staff Organization (PSO) meetings

Prepare the billing batch in the electronic patient management system.

Ensure/maintain the service cost in the patient management system.

High school diploma and/or equivalent certification/experience/training. (Required)

1 year progressive experience and demonstrated knowledge in clinical/professional credential verification. (Preferred)

Advise clinical managers during review of credentialing files.

Perform various data entry and information retrieval tasks using a computerized patient records system.

A minimum of 2 years of experience as a medical biller or similar role.

Must have the ability to multitask and manage time effectively.

Excellent written and verbal communication skills.

Outstanding problem-solving and organizational abilities

In depth knowledge of healthcare industry billing.

Detail oriented with strong organization, analytical and problem-solving skills.

Bachelor's degree in accounting, finance, or related work-experience

Experience with electronic claims processing and/or billing software

Excellent organizational skills and attention to detail

Strong communication and interpersonal skills

5+ years of experience in billing and accounting

Healthcare experience, experience with medical billing codes and terminology is a huge plus

Work environment: PAIC; Position is fully remote

One year experience in a Healthcare Field, Customer Service, Telemarketing, or Call Center environment (REQUIRED)

Working knowledge of Medical Terminology (REQUIRED)

Requires good written, oral, and telephone communication skills.

Requires knowledge of general office equipment, PCs, and associated software packages.

General knowledge of medical terminology preferred.

Process, review and maintain all practitioner/provider credentialing and re-credentialing files and offer solutions regarding the workflow of credentialing files.

Solid working knowledge of credentialing software applications and/or other relational databases like Access.

Excellent communication skills - both verbal and written.

Certification as a CPCS (Certified Provider Credentialing Specialist) by NAMSS preferred but not required.

Enter and update practitioner/provider data in the credentialing database while adhering to input standards.

Processes complete initial and re-credentialing applications within the expected timeframes.

Manage the status of accounts and balances and identify inconsistencies; manage cash applications and check the validity of debit accounts

Identify delinquent accounts, manage the dunning process and initiate outreach efforts to encourage timely collection

1-2 years of experience as a Billing Specialist or similar role

Excellent knowledge of MS Office

Bachelor's degree in Finance or Accounting

Experience in the SaaS Industry

Drafts correspondence and requests for information, following departmental SOPs, regulations and compliance requirements

Experience with Credential Stream preferred but not required

2 years experience in a healthcare credentialing/licensing environment REQUIRED

Direct experience with long-term care communities is preferred

Maintains ongoing communication by phone, text, email with clinicians requiring initial and appointment and/or reappointment credentialing across all platforms

Initiates credentialing process of clinicians within 1 day of onboarding launch