Meta Care

• Submit clean, accurate claims for cardiology services. • Manage and resolve denied, rejected, and underpaid claims, including appeals and payer follow-up. • Review EOBs and remittance advice to identify denial trends and root causes. • Work claims to resolution while meeting defined revenue cycle KPIs (e.g., first-pass acceptance rate, denial turnaround time, AR days). • Utilize eClinicalWorks EMR for charge entry, claim submission, and payment posting. • Verify insurance eligibility, benefits, and authorization requirements. • Communicate with commercial payers, Medicare, and Medicaid to resolve claim issues. • Maintain HIPAA compliance and billing accuracy standards.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are seeking an experienced Medical Billing Specialist with expertise in claims submission and denial management across medical (primary care and cardiology), dental, and anesthesia services. This role is ideal for a detail-oriented professional who understands payer requirements and drives results by improving first-pass claim acceptance, denial resolution time, and accounts receivable (AR) performance. - Submit clean, accurate claims for primary care, dental, and anesthesia services. - Manage and resolve denied, rejected, and underpaid claims, including appeals and payer follow-up. - Review EOBs and remittance advice to identify denial trends and root causes. - Work claims to resolution while meeting defined revenue cycle KPIs (e.g., first-pass acceptance rate, denial turnaround time, AR days). - Utilize eClinicalWorks EMR for charge entry, claim submission, and payment posting. - Verify insurance eligibility, benefits, and authorization requirements. - Communicate with commercial payers, Medicare, and Medicaid to resolve claim issues. - Maintain HIPAA compliance and billing accuracy standards. Qualifications - 2+ years of billing experience across medical and/or dental services, with exposure to anesthesia billing preferred. - Demonstrated success in denial management, appeals, and claims follow-up. - Strong working knowledge of CPT, ICD-10, and ADA coding. - Experience with eClinicalWorks or comparable EMR systems. - Highly organized, detail-oriented, and KPI-driven. Requirements - Multi-specialty billing (primary care; cardiology, dental, anesthesia). - Familiarity with anesthesia-specific billing workflows and modifiers. - Experience managing payer correspondence and formal appeals. - Comfort working toward measurable revenue cycle outcomes. Benefits - Compensation: $18-$22/hour. - Benefits eligibility varies based on hours worked.

We are seeking an experienced Provider Credentialing Specialist to join our growing team. The ideal candidate will have a strong background in multi-state credentialing, with specific experience credentialing for Primary, Cardiology, Dental, and Anesthesia providers. This role requires exceptional attention to detail, accuracy, and the ability to work independently while managing multiple provider files across various payors and states. Complete provider credentialing and recredentialing applications for multiple specialties, including Cardiology, Dental, and Anesthesia. Navigate and comply with state-specific Medicaid and Medicaid MCO credentialing requirements. Maintain accurate records of provider files, applications, and payer correspondence. Update and maintain provider information in credentialing databases such as CAQH, PECOS, NPPES, and other payor-specific platforms. Follow up with payors, providers, and internal teams to ensure timely completion of all credentialing processes. Build and maintain relationships with Insurance representatives throughout the credentialing process to ensure up-to-date and timely responses. Navigate through several different state portals to obtain the proper information to begin the credentialing or recredentialing process. Interpret and apply plan-specific rules and state requirements for credentialing in each assigned region. Support ongoing growth—currently managing credentialing for 11 states, 26 providers, and 141 locations (and expanding). Manage and track all work using an Excel spreadsheet.