Billing & Credentialing Specialist

Bleeding and Clotting Disorders Institute • Peoria, IL

5h • Hybrid

About The Position

BCDI is seeking a Billing & Credentialing Specialist to join their growing team. This role involves comprehensive responsibility for credentialing new providers and maintaining their information across various databases and tracking systems. Key tasks include preparing, tracking, and submitting initial and renewal credentialing applications for insurance plans and hospital privileges, while ensuring all provider files adhere to NCQA, CMS, state, federal, and organizational standards. Additionally, the specialist will verify healthcare charges using an automated billing system and conduct timely follow-up on claims and denials to maximize reimbursement. BCDI offers a supportive and friendly work environment with experienced, upbeat coworkers and knowledgeable managers who prioritize patient outcomes and team success. The company fosters a positive culture with opportunities for social interaction among staff.

Requirements

• High attention to detail and ability to prioritize responsibilities to ensure timely completion of assigned tasks
• Knowledge of medical terminology utilized in medical billing, current office practices and procedures, and basic math
• Ability to elicit and evaluate information, sometimes of a highly personal and sensitive nature
• Ability to read, interpret, and apply regulations, policies, and procedures

Nice To Haves

• 2+ years medical billing & provider credentialing experience preferred
• Medication billing a plus
• Experience with billing Part B drugs a plus

Responsibilities

• Assumes full responsibility for credentialing all new providers and the maintenance of provider information in all databases and tracking systems
• Preparing, tracking and submitting initial and renewal credentialing applications for insurance plans and hospital privileges
• Ensuring all provider files meet NCQA, CMS, state, federal, and organizational standards
• Verifies healthcare charges via an automated billing system
• Provides timely follow up for claims and claim denials to ensure maximum reimbursement

Benefits

• SIGNING BONUS!
• Health, vision & dental insurance: Excellent insurance plans at minimal cost to staff.
• Flex Spending Account or Health Savings account with generous employer match.
• Dependent Care Assistance.
• 401(k): BCDI matches 100% on the first 5% of salary invested.
• 120 Vacation hours, 40 sick hours & 11+ paid holidays annually.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 1-10 employees