Medical Credentialing Specialist

2 weeks ago

Fulton, United States Fulton family psychiatry Full time
Job DescriptionJob Description

join our dynamic and growing healthcare team dedicated to providing exceptional medical services to our community. We are committed to delivering high-quality care and ensuring a seamless experience for our patients. As we expand our services, we are seeking a skilled and detail-oriented Medical Credentialing, Billing, and Coding Specialist to join our team.

Key Responsibilities:

  • Perform medical credentialing tasks, including provider enrollment, credentialing, and re-credentialing with insurance companies and government payers.
  • Conduct thorough verification of provider credentials, licenses, and certifications to ensure compliance with regulatory standards.
  • Utilize knowledge of medical coding systems (such as ICD-10, CPT, and HCPCS) to accurately assign appropriate codes to medical procedures and diagnoses.
  • Generate and submit medical claims to insurance companies and government payers, ensuring adherence to billing regulations and guidelines.
  • Follow up on unpaid or rejected claims, resolve billing discrepancies, and appeal denied claims as necessary to maximize reimbursement.
  • Maintain up-to-date knowledge of healthcare regulations, payer policies, and coding guidelines to ensure compliance and minimize billing errors.
  • Collaborate with internal teams, including healthcare providers and administrative staff, to streamline billing processes and optimize revenue cycle management.
Company DescriptionFulton family psychiatryCompany DescriptionFulton family psychiatry

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