Verified Job
Back Office / Data Entry
Healthcare Billing and Credentialing Specialist
Back Office / Data Entry
#39936
Remote / WFH
All States Medicaid, Inc.
Job Description
Job Overview
We are seeking a dynamic and detail-oriented Healthcare Billing and Credentialing Specialist to join our dedicated healthcare team. In this vital role, you will be responsible for managing the billing processes, ensuring accurate and timely submission of claims, and maintaining comprehensive provider credentialing records. Your expertise will help streamline revenue cycle operations while ensuring compliance with industry standards and regulations. This position offers an exciting opportunity to contribute to high-quality patient care by supporting the administrative backbone of our healthcare services.
Responsibilities
Process and submit medical claims accurately across various Medicaid and Medicaid managed care plans, including insurance reimbursements.
Verify insurance coverage, benefits, and eligibility prior to claim submission.
Maintain up-to-date provider credentialing files in accordance with the various State Medicaid and Federal plan standards to ensure compliance with accreditation requirements.
Follow up on unpaid or denied claims promptly, resolving discrepancies and resubmitting as necessary to maximize revenue recovery.
Collaborate with client partners to gather required documentation, verify provider credentials, and ensure all licensing is current.
Keep detailed records of billing activities, credentialing status, and correspondence for audit purposes.
Stay informed about changes in State and Federal healthcare policies, medical terminology updates, and industry regulations to ensure ongoing compliance.
Qualifications
Proven experience in healthcare billing with a solid understanding of Medicaid managed care processes is desired.
Strong knowledge of medical terminology, insurance procedures, and State and Federal standards for credentialing.
Excellent organizational skills with the ability to manage multiple tasks efficiently while maintaining accuracy.
Familiarity with electronic health records (EHR) systems and billing software is preferred.
Ability to communicate clearly with providers, insurance companies, and clients to resolve billing issues effectively.
Prior experience in credentialing or working within a managed care environment is highly desirable. Join us in delivering exceptional healthcare support by ensuring smooth billing operations and rigorous credentialing practices! We are committed to fostering a positive work environment that values your expertise and encourages professional growth.
Pay: $42,000.00 - $50,000.00 per year
Benefits:
401(k)
401(k) matching
Dental insurance
Free parking
Health insurance
Paid time off
Vision insurance
Work Location: In person
We are seeking a dynamic and detail-oriented Healthcare Billing and Credentialing Specialist to join our dedicated healthcare team. In this vital role, you will be responsible for managing the billing processes, ensuring accurate and timely submission of claims, and maintaining comprehensive provider credentialing records. Your expertise will help streamline revenue cycle operations while ensuring compliance with industry standards and regulations. This position offers an exciting opportunity to contribute to high-quality patient care by supporting the administrative backbone of our healthcare services.
Responsibilities
Process and submit medical claims accurately across various Medicaid and Medicaid managed care plans, including insurance reimbursements.
Verify insurance coverage, benefits, and eligibility prior to claim submission.
Maintain up-to-date provider credentialing files in accordance with the various State Medicaid and Federal plan standards to ensure compliance with accreditation requirements.
Follow up on unpaid or denied claims promptly, resolving discrepancies and resubmitting as necessary to maximize revenue recovery.
Collaborate with client partners to gather required documentation, verify provider credentials, and ensure all licensing is current.
Keep detailed records of billing activities, credentialing status, and correspondence for audit purposes.
Stay informed about changes in State and Federal healthcare policies, medical terminology updates, and industry regulations to ensure ongoing compliance.
Qualifications
Proven experience in healthcare billing with a solid understanding of Medicaid managed care processes is desired.
Strong knowledge of medical terminology, insurance procedures, and State and Federal standards for credentialing.
Excellent organizational skills with the ability to manage multiple tasks efficiently while maintaining accuracy.
Familiarity with electronic health records (EHR) systems and billing software is preferred.
Ability to communicate clearly with providers, insurance companies, and clients to resolve billing issues effectively.
Prior experience in credentialing or working within a managed care environment is highly desirable. Join us in delivering exceptional healthcare support by ensuring smooth billing operations and rigorous credentialing practices! We are committed to fostering a positive work environment that values your expertise and encourages professional growth.
Pay: $42,000.00 - $50,000.00 per year
Benefits:
401(k)
401(k) matching
Dental insurance
Free parking
Health insurance
Paid time off
Vision insurance
Work Location: In person
