Billing & Credentialing Coordinator

The Bridge Inc.•New York, NY

8h•$55,000 - $60,000

About The Position

The Bridge offers supportive housing and behavioral health services to vulnerable New Yorkers facing behavioral health and substance use challenges. We provide individuals with the tools they need to pursue their dreams and live meaningful lives. The Bridge envisions a world where adults experiencing serious mental illness can live and thrive within their communities. As a recognized leader in developing and operating supportive housing and community-based programs, The Bridge has 70 years of experience helping New Yorkers with mental illness, including those affected by homelessness, incarceration, and institutionalization. Scope of Position: At The Bridge, we’re driven by a powerful mission to transform lives by offering help, hope, and opportunity to the most vulnerable in our community. As a comprehensive provider of evidence-based rehabilitative services—ranging from mental health and substance abuse treatment to housing, vocational training, healthcare, education, and creative arts therapies—we are dedicated to making a meaningful impact. As our Billing and Credentialing Coordinator, you’ll be at the heart of this mission, managing the essential credentialing process for our dedicated providers while handling billing for key programs.

Requirements

High school diploma or Equivalent.
Associate’s degree in healthcare services, health information management, or related field from college preferred or Certificate from a technical school for billing.
Certified Biller or Certified Provider Credentialing Specialist
Certificate/Diploma or proven knowledge in Medical Reimbursement and Coding
3-5 years of experience in healthcare billing and credentialing.
Strong understanding of Managed Care Payer rules and Medicare LCD and NCCI Edits.
Knowledge of OMH and OASAS regulations and procedures.
Knowledge of Medicare and CMS Behavioral Health guidance.
Versed in third-party payer, Medicaid, and Medicare billing and payment procedures.
Provider credentialing and Medicaid Excess Income process and procedure
Not-for-profit and Behavioral Health regulations.
General competence with computer systems.
Knowledge of NYS ePaces, eMedNY, CMS PECOS and NGS; Availity and AWARDS is a plus.
Interpersonal skills required for effective communication/troubleshooting with program personnel and insurance plan contacts.
Ability to establish and maintain effective working relationships.
Ability to research and analyze data.
Ability to work independently.

Responsibilities

Process agency wide provider and agency enrollment, credentialing, and revalidation through eMedNY, PECOS, Availity, CAQH.
Verify healthcare professionals’ licenses, credentials and qualifications are valid, up-to-date, and meet regulatory and organizational standards.
Keep comprehensive records of credentialing activities, including applications, verifications, and accreditation.
Provide advice on renewal dates for licenses and credentials.
Work closely with providers to provide guidance on credentialing compliance.
Respond to inquiries and facilitate communication to resolve credentialing issues.
Stay abreast of medical policy, local licensing, and certification requirements.
Work with healthcare professionals and various stakeholders to ensure compliance.
Prepare and maintain reports of credentialing activities.
Assist auditors with credentialing activities.
Manage payer credentialing, renewals, provider roster updates, and practice information requests.
Effectively manage clearinghouse claims issues.
Analyze and report on accounts receivable.
Research/Investigate/Resolve and communicate complex claims issues.
Perform other tasks assigned by the supervisor.