The Billing/Medical Administrative Assistant with Credentialing experience provides administrative support for the payer credentialing process (initial provider enrollment and re-enrollment). Work closely with appropriate staff to complete process. Collect all relevant information from the provider, provider’s malpractice insurer. Performs timely follow up for all outstanding provider enrollment applications and contracts. Understand Provider Enrollment requirements to ensure regulatory compliance, including but not limited to CAQH, NPPES, PECOS. Ensure that all provider files are maintained in an appropriate manner on an ongoing basis. Notify leadership of errors identified in a timely manner.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- General knowledge of procedure and diagnosis coding.
- Perform posting charges
- Perform completion of claims to payers
- Works/reviews all claims prior to their submission using department guidelines and Intergy billing system.
- Well-versed with all HIPAA Guidelines to ensure the protection of patient information from unauthorized inquiries.
JOB DESCRIPTION CLAUSE
Describes the general nature and work being performed and are not to be construed as an exhaustive list of responsibilities, duties and skills required of employees. This is subject to change at the discretion of the employer.
MINIMUM QUALIFICATION REQUIREMENTS:
- High school diploma or equivalent with 2-3 years of related experience in Medical Billing and Credentialing.
- Must be able to fluently speak, write and understand English
- Self-starter with good organizational skills
- Must possess excellent written and verbal communications skills