Credentialing and Enrollment Coordinator/Billing Specialist-Remote

Saint Francis Community Services•Salina, KS

2d•Remote

About The Position

The Credentialing and Enrollment Coordinator/Billing Specialist will be responsible for efficiently managing enrollments, re-credentialing, and new contract applications with various commercial and government health plans on behalf of Saint Francis Ministries. This position also performs coding review, billing, payment posting, aging, and denial follow up for the Revenue Operations Department. The position is responsible for processing claims and payments into our Electronic Health Records (EHR) Practice Management Systems (PMS) and legacy system platforms.

Requirements

High School diploma or equivalent.
Minimum of three years of Insurance credentialing and enrollment experience
Minimum of two years of billing experience in a healthcare setting, behavioral health preferred.
Must be 21 years of age.
Must have a valid Driver's License.
Must pass a drug screen, MVR, and Child Abuse and Neglect Central Registry clearance check.
Lifting Requirements of 30-50 lbs.

Responsibilities

Manage enrollments, re-credentialing, and new contract applications with various commercial and government health plans
Understanding of third-party payer guidelines and requirements
Proactively follow up on application progress and ensure timely completion
Communicate contracting and enrollment process effectively to clients and internal stakeholders
Handle CAQH maintenance for providers
Manage clearinghouse setup and enrollments
Safeguard insurance website and clearinghouse access credentials
Maintain accurate records and databases related to provider credentialing, contracts, and network development activities
Collaborate with internal teams to communicate and coordinate network changes, updates, and issues
Serve as a liaison between the organization and Insurance
Billing and management of claims for multiple programs and payers to achieve maximum reimbursement
Reviewing claims for accuracy
Reduce rejections and denials by scrubbing claims for timely and accurate submission
Resolve denial instances
Ability to work aging and contact payers and state programs for timely payment
Identifying and billing secondary and tertiary insurances
Payment posting into PMS and legacy system
Prepare Excel worksheets and reports as applicable.
Prepare or assist in preparing financial reports and projects