What are the responsibilities and job description for the Medical Biller & Credentialing Specialist position at Clinical Professional Connections?
Seeking a full time AR/Medical Billing and Credentialing Specialist.
AR/Biller
Our Credentialing Specialists ensure healthcare providers meet the necessary qualifications and credentials required for practice. This involves verifying professional licenses, education, training, and relevant certifications. Liaise with medical boards, insurance companies, and healthcare facilities to complete credentialing applications accurately and efficiently. Maintain credentialing databases, track expiration dates, and facilitate the renewal process to ensure ongoing compliance. Attention to detail, knowledge of healthcare regulations, and strong organizational skills are vital in this role to uphold quality standards and ensure providers are credentialed to deliver patient care.
Qualifications:
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AR/Biller
- Gather and verify invoices for appropriate documentation prior to payment
- Maintain accounts receivable records to ensure aging is up to date, credits and collections are applied, uncollectible amounts are accounted for, and miscellaneous differences are cleared
- Perform daily cash management duties, including the recording of bank deposits, updating and distribution of cash receipt logs, and posting of cash to the accounts receivable sub-ledger
- Monitor and collect accounts receivable by contacting clients via telephone, email, and mail
- Prepare analytical and ratio analyses relevant to A/R so management can gain a better understanding of how collection efforts are progressing
- Support other accounting and finance team members, inventory management, and cost accounting
- Prepare and submit charges to insurance; apply modifiers as needed for correct coding, assign ICD10 codes in proper sequencing
- Review claim payments for appropriate levels of reimbursement and identify inaccurate claims processing decisions by insurance companies
- Perform various claim collection actions including correcting and resubmitting claims to third party payers, contacting payers for claim status, and prepare appeals as needed
- Participate in educational activities and monthly staff meeting
Our Credentialing Specialists ensure healthcare providers meet the necessary qualifications and credentials required for practice. This involves verifying professional licenses, education, training, and relevant certifications. Liaise with medical boards, insurance companies, and healthcare facilities to complete credentialing applications accurately and efficiently. Maintain credentialing databases, track expiration dates, and facilitate the renewal process to ensure ongoing compliance. Attention to detail, knowledge of healthcare regulations, and strong organizational skills are vital in this role to uphold quality standards and ensure providers are credentialed to deliver patient care.
Qualifications:
- Bachelor's degree in Healthcare Administration or Associate’s Degree or related field
- Minimum of 2 -5 years of experience in medical Billing and Credentialing
- Strong attention to detail and organizational skill
- Excellent communication and interpersonal abilities
- Proficiency in Microsoft Office and eClinical Works software
- Knowledge of credentialing standards and regulations
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