Work with the Best
Billing & Credentialing Specialist I
Posted 09/13/2024
Company Overview
We provide mental and behavioral health services to children through adults from a relational frame combined with various Evidence-Based Practices. Our group therapy practice has 30 therapists who are enthusiastic and passionate about bringing about change in those they work with. We employ a full administrative support staff who love what they do and love the clients we serve. We are looking for a billing and coding specialist who is organized, efficient, friendly and wants to be apart of a team that truly cares about the Mission and Vision.
Summary/Objective
The Billing & Credentialing Specialist I is responsible for routine daily medical billing, applying patient and insurance payments, checking patient benefits and alerting patient of balances, assessing no-show/late cancellation fees and accompanied documentation, provider credentialing, help with records requests and internal audits.
Essential Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Daily insurance billing and patient collections, including no-show and late fees
- Prepare, review, and transmit claims using billing software, including electronic and paper claims processing
- Submit credentialing applications for providers and complete attestations and updates
- Follow-up with payers, patients, and other appropriate parties to collect open billing in a timely manner.
- Check eligibility and benefits verification
- Review patient bills for accuracy and completeness, and obtain any missing information
- Conduct internal chart audits
- Post insurance and patient payments and denials on a daily basis via incoming mail and by pulling EFT’s online through EMR
- Check each insurance payment for accuracy and compliance with contract discount
- Identify and bill for secondary or tertiary insurances
- Review accounts for insurance and patient follow-ups
- Answering patient inquiries pertaining to accounts
- Comply with HIPAA guidelines
- Navigate various health insurance plan websites
- Prepare and send out patient invoices
- Help with inventory and other tasks as needed
Competencies
- Some knowledge of insurance guidelines including HMO/PPO and other payer requirements and systems
- Excellent verbal and written communication skills.
- Proficient in Microsoft Office Suite or related software.
- Basic understanding of collection practices and laws.
- Familiar with CPT and ICD-10 coding
- Customer service and effective communication skills for interacting with patients and insurance companies regarding medical claims and payment
- Ability to act with discretion, tact, and professionalism in all situations.
- Extreme attention to detail.
- Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
- Ability to act with discretion, tact, and professionalism in all situations.
Supervisory Responsibility
This position has no supervisory responsibility.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Physical Demands
While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms.
This position requires the ability to occasionally lift office products and supplies, up to 15 pounds.
Position Type/Expected Hours of Work
Expected to work 40 hours per week. Monday through Friday
Work Remotely
No
Travel
No travel is expected for this position.
Required Education and Experience
- High school diploma or equivalent required
- 1 year of billing and coding experience in medical practice
Preferred Education and Experience
- Credentialing experience
- Mental and Behavioral Health Billing
Additional Eligibility Qualifications
- Excellent people skills, with an ability to partner with a dynamic team.
- Possess personal qualities of integrity, credibility, and commitment to the Center’s mission.
- Dependable and values their contribution to the team
- Ability to handle difficult phone calls
AAP/EEO
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Application Instructions:
Please compile the following documents and submit via email to ATTN: Dr. Becky Rudd @ [email protected]
- Upload a cover letter which details how your experience pertains to the minimum and preferred position criteria
- A resume
- 3 References