Medical Staff Credentialing Director is responsible for all aspects of the verification process for medical staff incumbents. Provides regulatory oversight and guidance to the credentialing process. Being a Medical Staff Credentialing Director maintains working knowledge and ensures continuing compliance with state, federal, and institutional standards and guidelines. Develops and implements policies and protocols related to medical staff verifications and ensures that the organization and staff are in accordance with organizational and industry standards. Additionally, Medical Staff Credentialing Director analyzes reports on applications and credential status to identify trends and improve the credentialing process. Presents files to the credentialing committee and may act as a liaison to state medical licensure boards regarding the status of license applications. Requires a bachelor's degree. May require Certified Provider Credentialing Specialist (CPCS). Typically reports to senior management. The Medical Staff Credentialing Director typically manages through subordinate managers and professionals in larger groups of moderate complexity. Provides input to strategic decisions that affect the functional area of responsibility. May give input into developing the budget. To be a Medical Staff Credentialing Director typically requires 3+ years of managerial experience. Capable of resolving escalated issues arising from operations and requiring coordination with other departments. (Copyright 2024 Salary.com)
Busy and growing dermatology clinic with multiple providers looking for a Medical Billing/Medical Credentialing applicant to join our team! At least 1 year experience in medical billing/credentialing required. Bilingual is a plus but not required.
Billing Duties:
- Follow up on unpaid or denied claims and resolve any billing discrepancies.
- Verify insurance coverages.
- Maintain accurate and up-to-date patient billing records. - Assist patients with billing questions at window and via telephone.
- Make calls to collect balances.
Credentialing Duties:
- Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications - Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid - Complete re-credentialing applications for commercial and government payers - Work closely with the Billing Manager and billing staff to identify and resolve any denials or authorization issues related to provider credentialing
Qualifications:
- Experience with ICD-10 and CPT coding.
- Strong understanding of medical terminology.
- Experience in using billing software and electronic health record systems. - Knowledge of provider credentialing and its direct impact on the practice’s revenue cycle
- Excellent attention to detail.
- Strong analytical and problem-solving skills.
- Ability to work independently and meet deadlines.
- Effective communication skills to interact with healthcare providers, insurance companies, and patients.
Note: Certification in medical billing and or credentialing.
We offer competitive compensation based on experience.
If you have the required qualifications and are looking for a challenging opportunity in medical billing, please apply with your resume attached.
Job Type: Full-time
Expected hours: 40.00 per week
Benefits:
Schedule:
Work Location: In person
Job Type: Full-time
Pay: From $19.00 per hour
Expected hours: 40 per week
Benefits:
Schedule:
Work setting:
Experience:
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Work Location: In person