Medical Billing and Credentialing Specialist

Job Overview
Job Type: Full-time - In Office - Located in Utah

Location: Sunset UT or Murray UT

Salary: $60,000 - $70,000/year

Job Summary:

We are seeking a detail-oriented Medical Biller & Credentialing Specialist to join our team. This role is responsible for managing medical billing processes, supporting in claim denials and ensuring timely reimbursements. Additionally, the specialist will oversee provider credentialing and re-credentialing with insurance networks and healthcare facilities. The ideal candidate will have experience in both medical billing and credentialing, possess strong organizational skills, and maintain accuracy in all tasks.

Key Responsibilities: Medical Billing & Insurance Claims:

• Review and verify patient information, coding, and insurance details for accuracy.
• Follow up on unpaid claims and resolve denials or rejections in a timely manner.
• Handle billing inquiries from patients and insurance companies.
• Maintain compliance with healthcare regulations, including HIPAA.

Medical Credentialing & Provider Enrollment:

• Complete initial provider credentialing and re-credentialing applications for various insurance carriers and healthcare organizations.
• Track provider credentialing status and ensure all documents are up to date.
• Manage communication with insurance companies regarding credentialing status and requirements.
• Maintain a database of provider credentials, licenses, certifications, and expirations.
• Work closely with providers and administrative teams to ensure compliance with credentialing requirements.

Qualifications & Skills:

• Minimum of 1 year of experience in medical billing and credentialing.
• Knowledge of medical billing codes (CPT, ICD-10, HCPCS) and insurance guidelines.
• Experience with EHR/EMR and billing software
• Familiarity with payer enrollment processes, CAQH, NPPES, and PECOS.
• Strong attention to detail and problem-solving skills.
• Excellent communication and organizational abilities.
• Ability to multitask and work independently in a fast-paced environment.

Education & Certifications:

• High school diploma or equivalent (required)
• Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) (preferred).
• Medical credentialing certification

Benefits:

• Competitive salary
• Health, dental, and vision insurance
• Paid time off (PTO) and holidays
• Retirement plan options
• Professional development opportunities

Job Type: Full-time

Pay: $60,000.00 - $70,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Ability to Commute:

• Murray, UT 84107 (Required)

Ability to Relocate:

• Murray, UT 84107: Relocate before starting work (Required)

Work Location: In person

Salary : $60,000 - $70,000