Medical Biller & Credentialing Specialist - Onsite

GeBBS Healthcare Solutions, Inc.•New York, NY

1d•Onsite

About The Position

The Billing and Credentialing Specialist is responsible for medical billing processes and overseeing provider credentialing activities. This role ensures accurate and timely claim submission, reimbursement, and compliance with payer requirements while maintaining provider credentials with insurance networks and regulatory bodies. This role is onsite in Jamaica, NY.

Requirements

3+ years of experience in medical billing or credentialing, or a related healthcare role
Familiarity with insurance verification, claims processing, and denial management
Experience with credentialing software and electronic medical record (EMR) systems
Strong attention to detail and organizational skills
Excellent communication and problem-solving abilities

Nice To Haves

Knowledge of CPT, ICD-10, and HCPCS coding preferred

Responsibilities

Prepare, review, and submit medical claims to insurance carriers in an accurate and timely manner
Verify patient insurance coverage and benefits prior to billing
Monitor claim status and follow up on unpaid or denied claims
Resolve billing discrepancies and work with payers to ensure proper reimbursement
Post payments, adjustments, and denials into the billing system
Maintain compliance with payer guidelines and healthcare regulations (HIPAA, etc.)
Communicate with patients regarding billing inquiries and payment options
Manage the credentialing and re-credentialing process for healthcare providers
Prepare and submit credentialing applications to insurance companies and regulatory agencies
Track application status and follow up to ensure timely approval
Maintain up-to-date provider records, licenses, certifications, and continuing education
Ensure providers are enrolled and active with appropriate payer networks
Monitor expiration dates and renew credentials as needed
Maintain compliance with organizational policies and industry standards