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SportsMed Physical Therapy

SportsMed is a leading orthopedic and sports physical therapy clinic offering a range of therapeutic services to clients, including physical therapy, in-home th

Medical Biller and Credentialing Specialist

Location

New Jersey

Posted

66 days ago

Salary

$22 - $26 / hour

Seniority

Senior

No structured requirement data.

Job Description

Medical Biller and Credentialing Specialist

SportsMed Physical Therapy

Title: Medical Biller & Credentialing Specialist Location: Glen Rock, NJ Department: Billing Job Description: 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. Responsibilities Credentialing 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 Billing Responsibilities - 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patient authorization issues - Review existing claims in billing software and follow up on outstanding issues - Review outdated claims in billing software to research and resolve as necessary - Review outdated claims in billing software and prepare for collection as necessary - Work with insurance companies to resolve billing issues - Work with patients to resolve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 Qualifications - 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 Benefits - Competitive pay based on experience - Medical, Dental, Vision insurance options - Life and disability insurance options - PTO, sick time, paid holidays. 401k - Excellent career growth opportunities - Pay Rate $22.00 - $26.00 per hour $22 - $26 an hour

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