Healthcare Billing and Credentialing Coordinator

2 weeks ago


Clearwater, United States Clinical Professional Connections Full time
Position Overview:
We are looking for a dedicated full-time Accounts Receivable and Medical Billing Coordinator to join our team at Clinical Professional Connections.

Key Responsibilities:
- Gather and validate invoices to ensure all necessary documentation is in place before processing payments.
- Maintain and manage accounts receivable records, ensuring that aging reports are current, credits and collections are accurately applied, and any uncollectible amounts are documented.
- Conduct daily cash management tasks, including recording bank deposits, updating cash receipt logs, and posting cash transactions to the accounts receivable sub-ledger.
- Proactively monitor and collect accounts receivable by reaching out to clients through various communication channels.
- Prepare analytical reports and ratio analyses related to accounts receivable to assist management in understanding collection progress.
- Collaborate with other accounting and finance team members on inventory management and cost accounting.
- Prepare and submit charges to insurance providers, ensuring correct coding and appropriate application of modifiers, as well as assigning ICD10 codes in the correct order.
- Review claim payments to verify appropriate reimbursement levels and identify any discrepancies in claims processing by insurance companies.
- Execute various claim collection actions, including correcting and resubmitting claims to third-party payers, following up on claim statuses, and preparing appeals when necessary.
- Engage in educational initiatives and participate in monthly staff meetings.

Credentialing Specialist Duties:
As a Credentialing Specialist, you will ensure that healthcare providers meet the essential qualifications and credentials required for practice. This includes:
- Verifying professional licenses, educational background, training, and relevant certifications.
- Liaising with medical boards, insurance companies, and healthcare facilities to accurately and efficiently complete credentialing applications.
- Maintaining credentialing databases, tracking expiration dates, and facilitating the renewal process to ensure ongoing compliance.

Qualifications:
- Bachelor's degree in Healthcare Administration or an Associate's Degree in a related field.
- A minimum of 2-5 years of experience in medical billing and credentialing.
- Strong attention to detail and exceptional organizational skills.
- Excellent communication and interpersonal abilities.
- Proficiency in Microsoft Office and eClinical Works software.
- Knowledge of credentialing standards and regulations.

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