What are the responsibilities and job description for the Credentialing and Billing Specialist position at Provident Inc / Mary Ryder Home?
Essential Duties and Responsibilities
- Supervise Billing Insurance Specialists
- Establish and maintain ClinicTracker/Billing Tracker system by updating insurance data and fee schedules
- Negotiate 3rd party insurance contracts
- Analyze client account balances and adjust/write off when necessary
- Approve financial assistance requests
- Set up client payment plans
- Complete necessary paperwork and process to credential clinicians in a timely manner
- Maintain and update any necessary information needed by insurance panels and CAQH
- Review credit balance report and issue refunds
- Assist in monthly client statement processing
- Learn and implement patient estimate software
- Seek knowledge to stay cognizant of current billing rules and regulations
- Act as backup to the Insurance Specialist
- Execute other duties as assigned
Competencies
- Functional/Technical Skills
- Integrity & Trust
- Organizing
- Problem Solving
- Attention to Detail
Other Skills Required
- Proficient in all Microsoft Office applications.
- Excellent communication skills, in person, in writing and over the phone.
- Great customer services both internally and externally
- Team player with a positive attitude and friendly demeanor
Supervisory Responsibilities
- This position will directly supervise the finance departments insurance specialists.
Working Conditions / Environment
- This position is full time, 40 hours per week. Generally, Monday through Friday 8:00am-5:00pm. Other occasional hours as necessary.
- Works out of Provident’s St. Louis City office, with option to work remotely no more than 50% of time?
- Ability to travel to other Provident sites and community-based locations, when needed???
- Must have a reliable high-speed internet connection to work remotely?
- Must be able to lift up to 20 pounds?
- Have the ability to sit for long periods of time?
- Work hours generally fall between Monday and Friday, 7:00 am – 6:00 pm, with availability to support employees outside of standard work hours, when needed?
Required Education & Experience
- High School Diploma with some college desired
- A minimum of one year of experience in insurance billing
The Billing Supervisor supports the organization by working with the Insurance Specialists and insurance companies to ensure that data/payments entered into the billing system are accurate and in compliance with current billing regulations to maximize revenue in order to sustain and grow our current programs.
