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Credentialing & Billing Specialist

4 months ago

Lafayette, United States Riggs Community Health Full time

Do you desire an active work life that's well supported, balanced, and family-oriented? If you are detail-oriented and customer-service minded then you'll enjoy Riggs HR Department. Riggs always strives for our "Joy in Work" efforts.

At** Riggs Community Health Center**, you will work directly with the HR Director, Managers, Director team, and Executives to accomplish tasks ranging from HR reception to assisting with broader organizational projects. This position reports to the CFO. We need a person that will thrive in a tech-savvy, multi-tasking, office administrative role. Join Riggs finance team and reap the rewards of a fulfilling career while continuing to help our community.

**Essential Duties**:

- Assists CFO with managed care contracting issues and projects.
- Compiles data necessary to credential and privilege providers.
- Credentials all Riggs CHC providers with contracted payers, re-validating facility and providers, as needed
- Monitors the adjustment summary report on a weekly basis to ensure that all transactions are correct and any discrepancies are corrected properly to patient accounts, by outside billing company, prior to month end.
- Reconciling specific GL accounts that relate to patient refunds, DWR adjustments, credit card payments. Assists with reconciling patient payments posted balance to actual cash received at month end.
- Maintains and updates CAQH for both Riggs CHC and individual providers.
- Work with outside billing company on billing or EHR system issues.
- Work with other departments to resolve ongoing issues.
- Drafts training material for PSRs, and assists in on-going training or other issues that arise, as needed.
- Monitors Medicaid panel, noting panel sizes and other requirements for UDS reporting.
- Sr. person to go to for assistance with billing and credentialing matters.

Monday - Friday (40 hours)