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Billing and Credentialing Specialist

1 month ago

Hilliard, United States Care360 Hospice Full time
Job DescriptionJob Description

Hospice Billing and Credentialing Specialist

 

Salary: $50-$60k/yr (BOE)

Schedule: Full time | M-F| 8am-430pm

Location: Hilliard, Ohio (HYBRID)

 

Requirements of the Hospice Billing and Credentialing Specialist role:

  • Proficient in the use of Google Suite, Microsoft Excel, Microsoft Word

  • Prior experience with Hospice billing and claims submission

  • Experience with medical provider credentialing process, policies, and procedures, including delegated credentialing requirements; familiarity with medical billing and claims payment system requirements as it relates to provider enrollment

  • Excellent attention to detail, with a high degree of accuracy; ability to manage multiple projects efficiently and accurately

 

The Hospice Billing and Credentialing Specialist role: 

  • Process initial and re-credentialing applications from providers, ensuring compliance with departmental requirements.

  • Accurately enter application data, conduct reviews for errors before submitting provider files for quality review, and meet departmental requirements.

  • Perform follow-up for provider files on "watch" status, as required by departmental guidelines.

  • Ensure timely follow-up for ongoing state license action monitoring reports.

  • Ensure timely follow-up for ongoing Medicare/Medicaid sanctions monitoring reports.

  • Prepare and distribute re-credentialing groups, meeting departmental requirements.

  • Complete 1st, 2nd, and 3rd requests for re-credentialing packets, as per departmental requirements.

  • Generate reports for various state plans/departments to identify providers who have not returned their re-credentialing applications or are past due for credentialing, adhering to departmental requirements.

  • Accurate logging of payments received from insurance companies and patients while maintaining current records and balances of all receivables

  • Maintain current records including billing addresses and numbers for contacting patients as needed

  • Follow up on delinquent payments and resubmit billing as needed

  • Follow up on $0 pays

  • Perform posting charges and completion of claims to payers

  • Submit billing data to the appropriate insurance providers

  • Process claims

  • Resolve denial instances and filing appeals

  • Assisting with faxing, answering phones, emails and text messages

  • Assisting with credentialing new providers under insurances

  • Running initial insurance verifications and benefits checks for new clients

  • Bi-monthly re-verification of benefits

Why work with Care 360 Hospice:

  • Medical, dental, and vision health Insurance

  • Paid Time Off 

  • 401(k) Matching

  • Life Insurance

  • Growth opportunities 

 

NEXT STEPS

We appreciate your interest in our Hospice Billing and Credentialing Specialist position. If you meet the requirements for this opportunity we will contact you regarding the next steps. 

 

3455 Mill Run Road Suite 100

Hilliard, Ohio 43026

 

Care 360 Hospice is an Equal Opportunity Employer M/F/D.