The Billing & Credentialing Specialist will work as part of the billing team to maximize the efficiency and accuracy of Ramey-Estep/Re-group (RE) billing activities. This will be achieved by reviewing prebilling reports to maximize payments, improving current processes, and reviewing post-billing reports to track denial trends to minimize denied and outstanding claims. This position will also assist in the management of the enrollment and credentialing process for healthcare providers.
High School Diploma or GED required.
An Associate’s Degree in Business, Medical Billing/Coding, or a related field is preferred. Work experience or other education may be considered in lieu of a degree.
Previous experience in medical billing/coding and provider enrollment/credentialing is required.
Previous experience preferred:
Must be at least 21 years of age.
Knowledge of professional fee billing for healthcare services, reimbursement, third-party payer regulation, and medical terminology is preferred.
Knowledge of Managed Care products such as HMO, PPO, and POS.
Ability to multitask, prioritize work, and meet deadlines.
Must have excellent organizational and time management skills.
Must be able to work independently or as part of a team.
Must be detail-oriented and possess a commitment to accuracy.
Must have excellent written and verbal communication and presentation skills; focused on solving the conflict cooperatively, not blame; keeps emotions under control.
Technical requirements include proficiency with Microsoft Word, Excel, PowerPoint, and other applications the organization or regulatory agencies use.
Ability to understand and relate to the needs of stakeholders from diverse backgrounds.
Ability to work effectively with staff, physicians, and external customers.
Ability to read, write, and converse in English.
Successful completion of a pre-employment drug screen.
Successful completion of a background screening.
Successful completion of a TB skin test or proof of a negative chest x-ray or other documentation.
Successful completion of Excellent Foundations.
Maintain 20 hours of annual training.
Basic Electronic Medical Record (EMR) system training.
The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
While performing the duties of this job, the employee is regularly required to stand, walk, talk, hear, and smell. The employee frequently is required to sit; use hands to finger, handle, or feel; reach with hands and arms; and stoop, kneel, crouch, and climb stairs. The employee is occasionally required to climb, balance or run. The employee must frequently lift and/or move up to 10 pounds or more. Specific vision abilities required by this job include close vision, distance vision, and peripheral vision.
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