Credentialing and Billing Specialist

• Responsible for gathering, tracking, and completing new appointment and re-appointment credentialing applications.
• Handle attestation requests and other provider directory requirements as required with individual insurance payers.
• Conducts primary source verification of all components of the application file.
• Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
• Coordinates, verifies, and monitors the Provider Enrollment process for Medicare, Medicaid, and the provider credentialing for other payors.
• Facilitates provider-related research based on denied claims.
• Researches and resolves provider related enrollment issues and coordinates with team members when necessary.
• Provide billing staff support with patient eligibility, charge entry, insurance claim submission, receipt posting and general office duties.

EDUCATION:

High School diploma or equivalent

EXPERIENCE:

• Two (2) years previous experience in medical office setting
• Experience with electronic medical record software preferred

QUALIFICATIONS:

• Must be able to work compatibly and efficiently within a team environment.
• Must be able and willing to share knowledge and information with team members.
• Ability to communicate in a professional manner (both written and verbal).
• Capable of properly documenting processes.
• The ability to use customer relation skills to enhance the customer experience.
• Knowledge of common medical practice processes and workflows.
• Excellent organizational skills and the ability to multi-task.
• Knowledge of medical terminology.
• Knowledge of Microsoft Office.
• Ability to maintain patient confidentiality according to Federal and State laws.
• Strong attention to detail, accuracy, and thoroughness are essential.

After an in-person orientation is complete, this will be a hybrid position that will require office time in Winston-Salem, NC, in addition to, working remotely in NC.