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Medical Billing Credentialling Specialist

3 months ago

Dublin, United States Total Care Therapy Full time
Job DescriptionJob Description

Medical Billing Credentialing Specialist

 

Salary: $65-$75k/yr 

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

Location: Dublin, Ohio (ON-SITE)

 

Requirements of the Medical Billing Credentialing Specialist role:

  • Proficient in the use of Google Suite, Microsoft Excel, Microsoft Word, CMS 1500, and Availity

  • Prior experience with medical billing and claims payment system requirements as it relates to provider enrollment

  • 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

 

About the Medical Billing 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.

  • Process a minimum number of provider applications each month, adhering to 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 Total Care Therapy:

  • Medical, dental, and vision health Insurance

  • Paid Time Off 

  • 401(k) Matching

  • Botox at a reduced rate

  • Life Time gym membership reduced rate

  • Therapists providing services within the community qualify for a gas stipend

 

About Us:

TCT is a growing therapist-owned and operated company providing Physical Therapy, Occupational Therapy, and Speech Therapy in the home and assisted living settings. We have a close-knit culture with competitive pay, flexible schedules, rewarding work, comprehensive benefits, paid time off, on-the-job training, and opportunities for upward mobility. We are engaging, and supportive, and our goal is to restore independence through compassionate and quality care.

NEXT STEPS

We appreciate your interest in our Medical Billing Credentialing Specialist role: position, one of our recruiters will connect with you shortly.

 

Total Care Therapy 

6099 Riverside Dr. Suite 207

Dublin, OH 43017

 

Total Care Therapy is an Equal Opportunity Employer M/F/D.