Credentialing and Billing Specialist - Remote

Overview

The Credentialing and Billing Specialist is responsible for managing the credentialing process for healthcare providers, ensuring compliance with various insurance payers, and providing support for billing operations.

In Short

• Gather and complete credentialing applications for new and re-appointed providers.
• Handle attestation requests and insurance payer requirements.
• Conduct primary source verification of application files.
• Identify and validate discrepancies in applications.
• Coordinate provider enrollment for Medicare, Medicaid, and other payors.
• Facilitate research on denied claims.
• Resolve provider enrollment issues with team collaboration.
• Support billing staff with patient eligibility and claim submissions.

Requirements

• High School diploma or equivalent.
• Two years of experience in a medical office setting.
• Experience with electronic medical record software preferred.
• Ability to work effectively in a team environment.
• Strong written and verbal communication skills.
• Detail-oriented with excellent organizational skills.
• Knowledge of medical terminology and common practice workflows.
• Proficient in Microsoft Office.
• Ability to maintain patient confidentiality.

Benefits

• Hybrid work model after orientation, with remote work options.
• Opportunity to enhance skills in medical billing and credentialing.
• Collaborative team environment.