Medical Biller Specialist
3 days ago
This role involves verifying the credentials of healthcare providers and enrolling them with various payers, such as Medicare and Medicaid.
Responsibilities:- Verify Provider Credentials: Confirm the qualifications, certifications, and licenses of healthcare providers.
- Enroll Providers: Facilitate the process of enrolling healthcare providers with payers, including commercial insurance companies.
- Prepare Applications: Develop and submit necessary documentation for credentialing and payer enrollment.
- Resolving Issues: Collaborate with payers to resolve any errors or discrepancies related to provider credentialing and enrollment.
- Record Maintenance: Keep accurate and up-to-date records of healthcare provider credentials and enrollment status.
- Regulatory Compliance: Ensure adherence to relevant regulations, such as HIPAA and state laws.
- Communication: Effectively communicate with healthcare providers, payers, and internal stakeholders to address credentialing and enrollment concerns.
- Education: A minimum of a high school diploma or equivalent, with a preference for associate's or bachelor's degrees.
- Work Experience: At least two years of experience in credentialing, medical billing, or a related field.
- Certifications: Holding a Certified Provider Credentialing Specialist (CPCS) or Certified Credentialing Specialist (CCS) certification is highly desirable.
- Skills: Possess strong analytical, organizational, and communication skills, with the ability to thrive in a fast-paced environment and meet deadlines.
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