Maintain individual provider files to include up-to-date information needed to complete the required governmental and commercial payer credentialing applications.
Maintain internal provider grid to ensure all information is accurate and logins are available.
Maintain accurate and up-to-date provider profiles on CAQH, PECOS, NPPES, and CMS databases.
Complete revalidation requests issued by government payers.
Complete credentialing, re-credentialing, and privileging applications to add providers to commercial payers, Medicare, and Medicaid.
Work closely with the Director of Revenue Cycle and billing staff to identify and resolve any denials or authorization issues.
Assist patients with billing inquires, payments, and account discrepancies.
Process all incoming and outgoing billing mail, following up as needed.
Post payments, adjustments, and zero-pay EOBs in an accurate and timely manner.
Posts patient payments in an accurate and timely manner to the appropriate line-item charge.
Research and resolve "unapplied and/or unidentified" payments to ensure monies are properly distributed.
Enter and balance payments as assigned by category (Check, Credit Card and/or Electronic Payments) by batch to internal deposit records for the day.
Process end of day reports (internal deposit slips and clearing of financial queue).
Identify collection issues with insurance or patient accounts and communicate to A/R Team.
Process and post all insurance recoupments.
Other duties as assigned by Supervisor.

Job Requirements:

Minimum 10 to 12 years of experience.
Fluent in Medical terminology.
Highly proficient in MS Office.
Strong organizational skills.
Strong attention to detail.
Strong interpersonal skills, including excellent written and verbal communication skills.

Job Title: Medical Billing & Credentialing Manager (100% Remote)

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