Billing and Credentialing Specialist

1 month ago


Duluth, United States Pandya Medical Center Full time
Job DescriptionJob Description

Pandya Medical Center is seeking an experienced Billing and Credentialing Specialist to join our team

Culture and Values: 

At Pandya Medical Center, we believe in going above and beyond for every patient. Our team members are dedicated professionals who truly care about making a difference. We listen, understand, and treasure each personal story shared by our patients. Our commitment extends beyond our clinic walls, with active involvement in community health fairs and volunteering initiatives. We are a highly reputed medical practice in North Atlanta, offering strong growth opportunities and robust benefits for our employees. Be a part of our dynamic team and take your career to the next level with Pandya Medical Center

Essential Duties and Responsibilities

Credentialing:

  • Review and process providers initial credentialing packets and supporting documentation.
  • Follows up with provider to ensure all information is obtained prior to onboarding
  • Completes and process payer enrollment applications for Providers for Medicare and submits required information to our PHO for credentialing for the remaining insurance carriers.
  • Completes timely follow up on all applications.
  • Maintains providers profiles and NPI’s, CAQH and internal spreadsheets.
  • Ensure that re-credentialing is complete timely to prevent any lapse in enrollment.
  • Monitor and maintain current documents (licenses, malpractice insurance).
  • Maintain confidentiality of all providers information

Billing:

  • Verifies coverage and eligibility as required and able to use insurance carrier portals for eligibility and claims information
  • Post charges and payments to correct accounts
  • Reviews patient bills and corrects any missing or inaccurate information in a timely and efficient manner
  • Follows up on unpaid claims and clears up discrepancies by telephone, fax or email communication
  • Investigate and appeal claims that were denied, following up and completing appeals in a timely manner
  • Complete data entry to update spreadsheets and reports

Required Skills:

  • Knowledge of insurance guidelines including HMO/PPO, Medicare and other payers’ requirements and systems
  • Competent use of computer systems, software and EHR’s (Athena Preferred)
  • Familiarity with CPT, ICD-10, and HCPCS Coding
  • Experience with Family Practice billing (Preferred)
  • Exceptional Customer Service skills for interacting with patients regarding medical claims and payments, including communication with patients and family members
  • Ability to work well in a team environment
  • Ability to triage priorities and handle conflict in a reasonable fashion
  • Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
  • Knowledge of medical terminology likely to be encountered on medical claims
  • Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
  • Ability to multitask
  • Preferred at least 2 years recent medical billing experience
  • Preferred at least 2 years credentialing experience


  • Duluth, Minnesota, United States Pandya Medical Center Full time

    Job Opportunity at Pandya Medical CenterWe are seeking a highly skilled and detail-oriented Medical Billing and Credentialing Specialist to join our team at Pandya Medical Center.About UsPandya Medical Center is a reputable medical practice in North Atlanta, dedicated to providing exceptional patient care and community involvement. Our team is committed to...


  • Duluth, Minnesota, United States Pandya Medical Center Full time

    Job OverviewCompany Culture:At Pandya Medical Center, we prioritize exceptional patient care and community involvement. Our dedicated team members are committed to making a meaningful impact in the lives of our patients. We actively participate in community health initiatives and volunteer efforts, reflecting our values and mission. As a reputable medical...


  • Duluth, United States Pandya Medical Center Full time

    Job DescriptionJob DescriptionCulture and Values: At Pandya Medical Center, we believe in going above and beyond for every patient. Our team members are dedicated professionals who truly care about making a difference. We listen, understand, and treasure each personal story shared by our patients. Our commitment extends beyond our clinic walls, with active...


  • Duluth, Minnesota, United States Pandya Medical Center Full time

    About the RolePandya Medical Center is seeking a highly skilled and experienced Senior Billing and Credentialing Manager to join our team. As a key member of our operations team, you will be responsible for leading our billing department and ensuring the accurate and timely submission of claims to insurance providers.Key ResponsibilitiesTeam Leadership:...


  • Duluth, Minnesota, United States Pandya Medical Center Full time

    Job OverviewPandya Medical Center is in search of a skilled Healthcare Billing and Credentialing Coordinator to enhance our dedicated team.Company Culture and Values:At Pandya Medical Center, we prioritize exceptional care for every patient. Our team comprises passionate professionals committed to making a significant impact. We value the unique stories...

  • Billing Specialist

    2 months ago


    Duluth, United States Nth Degree Full time

    Job DescriptionJob DescriptionWorking at Nth Degree, we don’t merely manage trade shows, exhibits, and events. Our job is to craft experiences that help build stronger brands—and we relish it. Live events are back, and we are busier than ever! We are looking for a Billing Specialist to add to our Finance team. As a Billing Specialist, you will operate as...

  • Billing Specialist

    2 weeks ago


    Duluth, United States Pandya Medical Center Full time

    Job DescriptionJob DescriptionCulture and Values: At Pandya Medical Center, we believe in going above and beyond for every patient. Our team members are dedicated professionals who truly care about making a difference. We listen, understand, and treasure each personal story shared by our patients. Our commitment extends beyond our clinic walls, with active...


  • Duluth, Minnesota, United States St. Luke's corporation Full time

    POSITION OVERVIEWThe Insurance Billing Specialist is tasked with the critical function of investigating, amending, and updating any inaccuracies or omissions related to account identifiers, insurance details, guarantor information, or other essential medical data. This role involves precise invoicing and the appropriate reconciliation of financial charges....


  • Duluth, Georgia, United States Nth Degree Full time

    Position OverviewAt Nth Degree, we specialize in creating impactful experiences that enhance brand visibility through trade shows, exhibits, and events. Our commitment to excellence drives us to seek a dedicated Billing Specialist to join our Finance team.As a Billing Specialist, you will serve as a key point of contact for billing processes and management,...


  • Duluth, Georgia, United States Nth Degree Full time

    Position OverviewAt Nth Degree, we specialize in creating impactful experiences through trade shows, exhibits, and events that enhance brand visibility. Our commitment to excellence drives us to seek a dedicated Billing Specialist to join our Finance team.As a Billing Specialist, you will serve as a crucial link between billing operations and management,...


  • Duluth, Georgia, United States Nth Degree Full time

    Position OverviewAt Nth Degree, we specialize in creating impactful experiences that enhance brand visibility through trade shows, exhibits, and events. As we navigate the resurgence of live events, we are seeking a dedicated Billing Specialist to join our Finance team.This role serves as a critical link between billing and management, overseeing essential...


  • Duluth, Minnesota, United States Nth Degree Full time

    Client Support SpecialistOverview:We are in search of a dynamic Client Support Specialist who excels in managing multiple tasks efficiently.Key Responsibilities:Oversee billing processes, time tracking, and payroll for designated events.Input labor data, inventory consumption, and acquisitions into the system.Offer assistance to event labor teams and...


  • Duluth, Minnesota, United States Millennium Health Full time

    Job SummaryMillennium Health is seeking a skilled Phlebotomy Specialist to join our team. As a key member of our laboratory staff, you will be responsible for collecting patient specimens, processing and packaging collections, and serving as an intermediary between healthcare providers and our laboratory.Key ResponsibilitiesCollect patient urine and/or oral...


  • Duluth, Minnesota, United States Millennium Health Full time

    Full Time Specimen Collection SpecialistLocation: Duluth, MinnesotaSchedule: Full Time. Schedule VariesSeeking: Candidates must be willing to travel around Northern MinnesotaJoin us in making a meaningful difference in your community.Millennium Health LLC is a recognized specialty laboratory with over a decade of expertise in medication monitoring and drug...


  • Duluth, Minnesota, United States AMN Healthcare Full time

    Position: Gastrointestinal Specialist Start Date: ASAP Compensation: $3099 per week. This healthcare facility is seeking a Gastrointestinal Specialist for temporary staffing support to address an immediate requirement. Schedule: Monday - Friday, 8:00 AM - 5:00 PM Work Environment: Outpatient Clinic Responsibilities: Conduct general gastrointestinal...


  • Duluth, Minnesota, United States Millennium Health Full time

    Full Time Specimen Collection SpecialistLocation: Duluth, MinnesotaSchedule: Full Time. Schedule VariesSeeking: Candidates must be willing to travel around Northern MinnesotaJoin our team at Millennium Health LLC, a certified specialty laboratory focused on medication monitoring and drug testing services. We are in search of a Specimen Collection Specialist...


  • Duluth, Minnesota, United States AMN Healthcare Full time

    Position OverviewWe are currently seeking a dedicated Gastrointestinal Specialist to join our team for locum tenens support. This role is essential in addressing a pressing need within our healthcare facility.Key Responsibilities:Provide comprehensive care in a clinic environment.Perform general gastrointestinal procedures.Manage a daily schedule that...


  • Duluth, Minnesota, United States SIS, LLC Full time

    Job OverviewThe Senior Accounting Specialist will report directly to the Corporate Controller. This role involves supporting daily office and financial operations, collaborating with the company's consultants to enhance administrative efficiency, and assisting partners and managers as needed.Payroll expertise is essential.KEY RESPONSIBILITIESThe key...


  • Duluth, Minnesota, United States AMN Healthcare Full time

    Position Overview & RequirementsRole: Gastrointestinal SpecialistPay Rate: $ $ This healthcare facility is in need of a Gastrointestinal Specialist for temporary support as they seek to address a current demand.Key Details & Requirements:Immediate Start - OngoingMonday - Friday, 8:00 AM - 5:00 PMOutpatient SettingGeneral Gastrointestinal ProceduresA typical...


  • Duluth, United States Service Experts Full time

    Position: Customer Service Specialist Location: 2500 Meadowbrook Pkwy Suite F, Duluth, GA 30096 (on-site) Schedule : 2:00pm-10:30pm EST (includes weekends with two consecutive weekdays off) Pay: $18.50 per hour Why You Should Join the Service Experts Team?  Our team consists of the very best; we believe in doing what is right for our customers and our...