Medical Biller & Credentialing Specialist

SportsMed Physical Therapy•Glen Rock, NJ

1d•$22 - $26•Hybrid

About The Position

SportsMed Physical Therapy is seeking a Medical Biller/Credentialing Specialist to join our team. This position will begin training on site full-time in either Glen Rock, NJ or Franklin Lakes, NJ and will transition to Hybrid-Remote after 2-3 months at the discretion of the billing manager. Candidates for this role must be local to the New Jersey area. This is a dual-role that combines medical billing/AR with oversight of the provider credentialing process SportsMed is one of New Jersey’s leading providers of physical rehabilitation services. We can offer you a fast paced and challenging career opportunity. If you are passionate about healthcare, motivated and want to make a difference, SportsMed is the place for you. Check out our website at: http://spineandsportsmed.com/

Requirements

Minimum 4 years’ experience with medical billing required and minimum 2 years' experience with provider credentialing process required
Solid understanding of medical billing software and procedures preferred (Kareo, WebPT, Navinet, CMD, etc.)
Knowledge and understanding of Pecos, NPPES, and CAQH
Ability to multitask and manage time effectively with minimum supervision
Excellent written and verbal communication skills
Strong basic Excel skills
Outstanding problem-solving and organizational abilities
Keen attention to detail with strong analytical skills
A professional, courteous, enthusiastic, and conscientious attitude, willing to fulfill group goals and work requirements
Ability to deal positively with coworkers and supervisors, and support management decisions
Ability to function as a contributing team member while meeting deadlines and productivity standards
Out-of-network and in-network billing experience

Responsibilities

Oversee the credentialing and recredentialing process for providers and ensure completion in a timely manner
Maintain provider credentialing database
Communicate with providers to collect documentation and complete necessary credentialing steps
Communicate with insurance networks to coordinate provider enrollment
Monitor credentialing timelines and keep track of necessary recredentialing steps
Stay informed of industry regulations and credentialing requirements
Must have knowledge of Pecos, NPPES, and CAQH
Review new patient records in billing software and initiate billing process
Work with clinic staff to resolve patient authorization issues
Review existing claims in billing software and follow up on outstanding issues
Review outdated claims in billing software to research and resolve as necessary
Review outdated claims in billing software and prepare for collection as necessary
Work with insurance companies to resolve billing issues
Work with patients to resolve billing and collection issues
Ensure all billing changes, charge offs, escalations, interactions etc. are correctly documented in billing and/or HRM software in a timely manner
Properly escalate billing issues where necessary
Follow company processes and procedures carefully
Prepare and update summary documentation as required
Other duties as assigned by management