Billing & Credentialing Specialist

Description

Care Alliance Health Center is a Federally Qualified Health Center and is a leading provider of high-quality medical, dental, behavioral health care, and more. We have been serving the Cleveland community for more than 35 years.

About the Job  

Care Alliance Health Center is looking for an experienced Credentialing & Billing Specialist  

 
Mission Statement: Our mission is to provide high-quality, comprehensive medical and dental care, patient advocacy and related services to people who need them most, regardless of their ability to pay. We are looking for an experienced and proven Credentialing & Billing Specialist. This role will maintain accurate provider information, support billing operations, and ensure adherence to credentialing and billing guidelines.

Requirements

Responsibilities:

Assist the Revenue Cycle Manager in identifying and resolving denials or authorization issues. Process billing mail and follow up as needed. Support the management of outstanding accounts receivable. Maintain familiarity with National Billing and Coding standards and regulations and ensures Care Alliance remains in compliance with them. Assist in training staff on billing procedures and policies as they relate to entering patient data into the Practice Management System. Perform other duties as assigned

Qualifications:

Minimum of 5 years of experience in healthcare credentialing and/or billing, or provider contract management experience Minimum of 2 years’ experience in managed care practices, payor reimbursement methodologies, regulatory standards (e.g., NCQA), and records management.  Excellent computer skills, including Microsoft Word, Access, and Excel Experience with Adobe Acrobat Professional and credentialing software preferred Good oral/written communication skills, computer literacy, business acumen, organizational and interpersonal skills are a

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