Credentialing and Billing Coordinator

2 weeks ago

Phoenix, Arizona, United States Axiom Care Full time

Job Type

Full-time

Company Overview

Axiom Care is a dynamic and rapidly expanding provider of substance abuse treatment and sober living accommodations, primarily serving low-income and justice-involved individuals in the Phoenix metro area and Apache Junction. Our mission is to facilitate positive life changes through comprehensive care, including medical services, professional counseling, case management, housing support, and employment assistance.

Position Summary

The Credentialing and Billing Coordinator is responsible for ensuring that all medical practitioners maintain valid credentials and licenses necessary for legal practice in their respective fields. This role also involves managing the active status of all providers and processing insurance claims for medical services provided, diligently following up on claims until resolution. Additionally, the coordinator will assist patients with HEA Plus applications.

Key Responsibilities

  • Verify documentation accuracy for coding and billing purposes.
  • Submit claims and manage all communications related to submitted claims.
  • Maintain and update active reports for billing and billable items.
  • Conduct utilization reviews, including submitting and monitoring prior authorizations.
  • Analyze denials for reprocessing.
  • Post insurance payments against claims using billing software.
  • Confirm client eligibility prior to billing.
  • Follow up on insurance eligibility for pending enrollments.
  • Participate in meetings related to clearinghouse, billing, and provider relations.
  • Ensure that medical providers uphold current credentials and licenses.
  • Complete initial and subsequent credentialing packets for active facility payor sources.
  • Manage current contracts, including effective and renewal dates for all payors.
  • Oversee the credentialing of new onboard providers and maintain records for current staff.
  • Coordinate facility credentialing and follow-up processes.
  • Review provider files to ensure appropriate documentation for credentialing.
  • Demonstrate proficiency in data entry.
  • Assist in completing HEA Plus applications for eligible patients and track application statuses.
  • Coordinate credentialing and re-credentialing applications and conduct document research.
  • Collaborate with providers to ensure timely submission of application information.
  • Act as the primary contact for credentialing needs of all new providers.
  • Perform additional duties as assigned by management.

Qualifications

Required Skills and Abilities

  • Exceptional verbal and written communication skills.
  • Strong interpersonal and customer service abilities.
  • Excellent organizational skills with a keen attention to detail.
  • Proficient time management skills with a proven ability to meet deadlines.
  • Strong analytical and problem-solving capabilities.
  • Ability to prioritize and delegate tasks effectively.
  • Capability to thrive in a fast-paced and sometimes stressful environment.
  • Proficient in Microsoft Office Suite or similar software.
  • Maintain a high level of patience.
  • Active CPR and First Aid certification required.
  • Possess an active Fingerprint Clearance Card.
  • Negative TB Test result within the past 12 months.

Required Competencies

  • Compliance and Ethics - Demonstrates commitment to the facility's mission and promotes cooperation between corporate staff and other departments.
  • Planning and Organizing - Effectively organizes facility and provider contracts to ensure timely completion and submission of documentation.
  • Quality Orientation - Monitors work to meet quality standards, demonstrating thoroughness and attention to detail.
  • Collaboration - Builds constructive relationships with clients, other work units, and community organizations to achieve mutual goals.
  • Client Care - Prioritizes client needs and works to exceed their expectations.
  • Cultural Competence - Respects and relates well to individuals from diverse backgrounds and understands various worldviews.

Education and Experience

  • High School Diploma or equivalent.
  • A minimum of two years of related experience is required.

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