Credentialing Specialist
Full-Time 22 - 26 USD per-hour-wageJob Overview
SportsMed Physical Therapy is seeking a 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.
Check out our website at: http://spineandsportsmed.com/
SportsMed Physical Therapy is seeking a 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.
Check out our website at: http://spineandsportsmed.com/
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
- 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- Review outdated claims in billing software to research and resolve as necessary
- Review outdated claims in billing software and prepare for collection as necessary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
Credentialing Responsibilities
Billing Responsibilities
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
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