Job Summary
We are seeking a detail-oriented and proactive Medical Biller & Credentialing Specialist to join our dynamic healthcare team. Is familiar with FQHC billing fee for service. In this role, you will be responsible for managing the billing process, ensuring accurate and timely submission of claims, and overseeing credentialing procedures to maintain compliance with industry standards. Your expertise will help streamline revenue cycle operations, enhance provider credentials, and support the delivery of high-quality patient care. This position offers an exciting opportunity to contribute to a fast-paced healthcare environment where precision and efficiency are paramount.
Responsibilities
- Prepare and submit accurate medical claims to various insurance payers, including managed care organizations, government programs, and private insurers.
- Follow up on unpaid or denied claims promptly to maximize reimbursement and resolve discrepancies.
- Verify patient insurance coverage, eligibility, and benefits prior to service delivery.
- Maintain comprehensive records of billing activities, claims status, and payment histories.
- Manage provider credentialing and re-credentialing processes in accordance with NCQA (National Committee for Quality Assurance) standards to ensure ongoing compliance.
- Collaborate with healthcare providers to gather necessary documentation for credentialing applications and updates.
- Stay informed about changes in managed care policies, billing regulations, and industry best practices to ensure adherence and optimize revenue cycle management.
Qualifications
- Proven experience in medical billing with a strong understanding of medical terminology and coding practices. Familiar with CPT, ICD-10 and HCPCS coding.
- Prior experience working within a medical office setting is highly preferred.
- Knowledge of managed care plans, insurance processes, and NCQA standards is essential.
- Excellent organizational skills with attention to detail to ensure accuracy in billing and credentialing tasks.
- Strong communication skills for effective collaboration with providers, payers, and patients.
- Ability to navigate various billing software systems efficiently.
- Familiarity with healthcare regulations and compliance requirements related to billing and credentialing. Join us in making a meaningful difference by ensuring smooth financial operations and maintaining high standards of provider accreditation!
Pay: $23.00 - $28.00 per hour
Benefits:
- 401(k)
- AD&D insurance
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
